Provider Demographics
NPI:1093941197
Name:CLAYTON, JENNIFER D (PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:D
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:STE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2400
Mailing Address - Fax:336-802-2001
Practice Address - Street 1:721 N ELM ST
Practice Address - Street 2:STE 101
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3929
Practice Address - Country:US
Practice Address - Phone:336-802-2205
Practice Address - Fax:336-802-2599
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC3506103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6001174Medicaid
NC6001174Medicaid