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1225751431
EDWARD R CLARKE
BRANDON, MS
NPI
1225751431
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2022-09-22
Last Update Date
2022-09-22
Business Address
EDWARD R CLARKE
613 MARQUETTE RD
BRANDON, MS 39042-3038
Phone number: 601-824-1692
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Mailing Address
EDWARD R CLARKE
PO BOX 88
BRANDON, MS 39043-0088
Phone number: 601-824-1692
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