NPI 1255464855 · live from the CMS NPI Registry
Susan D Clemons, PhD.
Psychologist, Clinical in Fayetteville, AR. National Provider Identifier 1255464855, active.
NPI record
| NPI | 1255464855 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 2013 N Green Acres Rd, Suite C, Fayetteville, AR 72703 |
| Practice phone | 479-444-3354 |
| Enumerated | March 13, 2007 |
| Last updated | April 28, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical primary | 103TC0700X | 06-22P (AR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.