Individual
MISS EVETTE M CLAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SERVICE FACILITATOR
Contact information
Practice address
3618 HUCKSTEP RD, BRODNAX, VA 23920-3029
(434) 632-0937
(434) 632-0937
Mailing address
3618 HUCKSTEP RD, BRODNAX, VA 23920-3029
(434) 632-0937
(434) 632-0937
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0257468725
—
VA
Enumeration date
10/03/2018
Last updated
10/03/2018
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