Individual
ANDRE B CLAYBORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
5101 S NEVADA AVE, SUITE 120, SIOUX FALLS, SD 57108-2213
(605) 361-9550
(605) 361-9582
Mailing address
5101 S NEVADA AVE, SUITE 120, SIOUX FALLS, SD 57108-2213
(605) 361-9550
(605) 361-9582
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPCMH2059
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6575380
—
SD
Enumeration date
11/03/2005
Last updated
08/16/2011
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