| Doctor Name: | NANCY JOAN CLODFELTER |
| NPI Number: | 1154530038 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD, L.P.C |
| License Number: | |
| Business Practice Address: | 6000 Kanakanak Road Dillingham, AK - 995760130 |
| Business Phone Number: | 9078425201 |
| Business Fax Number: | 9078429250 |
| Mailing Address: | Po Box 130, Medical Staff Office DILLINGHAM |
| State: | AK |
| Postal Code: | 995760130 |
| Phone Number: | 9078429218 |
| Fax Number: | 9078429250 |
| NPI Enumeration Date: | 05/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |