Individual
KIMEYARUS LASHA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 WHITE ST, MCCOMB, MS 39648-2711
(601) 249-4217
(601) 249-4234
Mailing address
150 JEFFERSON DAVIS BLVD, NATCHEZ, MS 39120-5107
(601) 446-6634
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/12/2015
Last updated
11/22/2024
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