Provider Demographics
NPI:1326461161
Name:WILLE, CLARA
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:WILLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1962 W LIBERTY ST APT 9
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4553
Mailing Address - Country:US
Mailing Address - Phone:914-466-8895
Mailing Address - Fax:
Practice Address - Street 1:1962 W LIBERTY ST APT 9
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4553
Practice Address - Country:US
Practice Address - Phone:914-466-8895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical