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1417638800
ANTOINETTE KELLY-CLARK
RUSTON, LA
NPI
1417638800
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
103TC1900X Psychologist, Counseling
Enumeration Date
2023-07-27
Last Update Date
2024-08-22
Business Address
Mrs. ANTOINETTE KELLY-CLARK
171 WATER TANK RD
RUSTON, LA 71270-8550
Phone number: 318-548-7242
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Mailing Address
Mrs. ANTOINETTE KELLY-CLARK
171 WATER TANK RD
RUSTON, LA 71270-8550
Phone number: 318-548-7242
Copy
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