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1588943161
ANTIONETTE K CLARK
VICKSBURG, MS
NPI
1588943161
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2011-08-12
Last Update Date
2011-08-12
Business Address
ANTIONETTE K CLARK
3444 WISCONSIN AVE
VICKSBURG, MS 39180-5331
Phone number: 601-638-0031
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Mailing Address
ANTIONETTE K CLARK
3444 WISCONSIN AVE
VICKSBURG, MS 39180-5331
Phone number:
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