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Individual

MS. KIMBERLY MICHELLE DYE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1015 SASSE ST, CLARKSDALE, MS 38614-7533
(662) 645-9050
Mailing address
110 YAZOO AVE STE 220, CLARKSDALE, MS 38614-4329

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
777666888
MS
05
82-1109893
MS
Enumeration date
09/06/2017
Last updated
03/17/2018
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