Individual
MR. WILLIAM CLAYTON OBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
1911 PLEASANT AVE. SOUTH, CREATE, INC, MINNEAPOLIS, MN 55403
(612) 874-9811
(612) 874-9820
Mailing address
1911 PLEASANT AVE. SOUTH, CREATE, INC, MINNEAPOLIS, MN 55403
(612) 874-9811
(612) 874-9820
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301760
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
301760
LADC
MN
Enumeration date
01/22/2008
Last updated
01/22/2008
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