| Doctor Name: | CLAYTON RIVERS |
| NPI Number: | 1144625054 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | CDCA131566 |
| Business Practice Address: | 476 W Market St Xenia, OH - 453852815 |
| Business Phone Number: | 9373768700 |
| Business Fax Number: | |
| Mailing Address: | 452 W Market St, XENIA |
| State: | OH |
| Postal Code: | 453852815 |
| Phone Number: | 9373768700 |
| Fax Number: | |
| NPI Enumeration Date: | 11/04/2014 |
| NPI Last Update Date: | 11/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CDCA131566 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |