Provider Information for 1003054891
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Mrs. REBECCA MAY CLINTON LCSW
Other Names:Former Name:REBECCA MAY FORDSex: Female
NPI: 1003054891
Last Updated: 2023-09-26
Certification Date: 2023-09-26
Certification Date: 2023-09-26
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1003054891 | ||||||||
| Enumeration Date | 2009-02-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6370 BOSCOMB PL COLORADO SPRINGS, CO 80922-2106 United States Phone: 405-474-9630 | Fax: | ||||||||
| Primary Practice Address | 6370 BOSCOMB PL COLORADO SPRINGS, CO 80922-2106 United States Phone: 405-474-9630 | Fax: | ||||||||
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