Individual
CLAYTON T WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2701 N MILDRED AVE APT 3A, CHICAGO, IL 60614-1407
(872) 254-4563
Mailing address
2701 N MILDRED AVE APT 3A, CHICAGO, IL 60614-1407
(872) 254-4563
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
149026718
IL
Other
Enumeration date
11/11/2022
Last updated
03/18/2025
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