Individual
CLAYTON LENNON SIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
N27W23957 PAUL RD, SUITE 101, PEWAUKEE, WI 53072-6223
(262) 278-4462
Mailing address
N27W23957 PAUL RD, SUITE 101, PEWAUKEE, WI 53072-6223
(262) 278-4462
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
15618131
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15618131
STATE LICENSE
WI
Enumeration date
02/19/2016
Last updated
02/19/2016
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