Individual
MRS. ELEANOR KLINE CLAYCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED L.C.S.W.
Contact information
Practice address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 526-5547
(715) 526-5542
Mailing address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 526-5547
(715) 526-5542
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4296-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39212900
—
WI
Enumeration date
09/06/2007
Last updated
09/03/2013
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