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1942605852
KELLY CLARK
BOONEVILLE, MS
NPI
1942605852
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MS BS Degree)
Enumeration Date
2014-11-04
Last Update Date
2014-11-04
Business Address
Miss KELLY CLARK
2301 E CHAMBERS DR
BOONEVILLE, MS 38829-8903
Phone number: 662-728-3154
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Mailing Address
Miss KELLY CLARK
2301 E CHAMBERS DR
BOONEVILLE, MS 38829-8903
Phone number: 662-728-3154
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