Individual
MS. PEGGY ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
809 WESTSIDE DR, BELZONI, MS 39038-3055
(662) 836-9857
Mailing address
809 WESTSIDE DR, BELZONI, MS 39038-3055
(662) 836-9857
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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