Provider Demographics
NPI:1265800031
Name:CLEMENS-CLAYTON, CAMILLE W (PHD)
Entity type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:W
Last Name:CLEMENS-CLAYTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9829
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387-6829
Mailing Address - Country:US
Mailing Address - Phone:936-697-1468
Mailing Address - Fax:
Practice Address - Street 1:800 RIVERWOOD CT
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2890
Practice Address - Country:US
Practice Address - Phone:936-697-1468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36809103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical