Provider Demographics
NPI:1851679096
Name:CLAYTON, MICHAEL SCOTT
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SCOTT
Last Name:CLAYTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13815 MARTINIQUE LN
Mailing Address - Street 2:
Mailing Address - City:MONT BELVIEU
Mailing Address - State:TX
Mailing Address - Zip Code:77523-2138
Mailing Address - Country:US
Mailing Address - Phone:801-380-1476
Mailing Address - Fax:
Practice Address - Street 1:4544 EAST FWY
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-8881
Practice Address - Country:US
Practice Address - Phone:281-420-4520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8033534-4104235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist