Clemons, Susan D
Clemons, Susan D is an sole proprietor health care provider with primary practice located at 2013 N Green Acres Rd Suite C, Fayetteville AR 72703. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Clemons, Susan D can be contacted via phone (479) 444-3354.Contact Information
Primary practice address
2013 N Green Acres Rd Suite C
Fayetteville AR 72703
Phone: (479) 444-3354
Fax: (479) 555-6770
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 06-22P | Arkansas |
Profile Details
| NPI number | 1255464855 |
|---|---|
| LBN Legal business name | Clemons, Susan D |
| Credentials | PHD. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 13th, 2007 |
| Last updated | Apr 28th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255464855 | NPPES |
| Illinois | Other | 20-5113370 | TAX IDENTIFICATION NUMBER |
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