Individual
JOHN CLEMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
239 METHODIST BLVD, HATTIESBURG, MS 39402-1297
(601) 296-2125
(601) 268-8645
Mailing address
239 METHODIST BLVD, HATTIESBURG, MS 39402-1297
(601) 296-2125
(601) 268-8645
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
52911
MS
103TC0700X
Clinical Psychologist
52911
MS
103TC2200X
Clinical Child & Adolescent Psychologist
52911
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03051508
—
MS
Enumeration date
10/13/2006
Last updated
10/08/2020
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