Individual
DONTA LASHARRA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
106 SHEMPER DR APT 3, HATTIESBURG, MS 39401-4419
(601) 329-5875
Mailing address
106 SHEMPER DR APT 3, HATTIESBURG, MS 39401-4419
(601) 329-5875
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/19/2021
Last updated
10/22/2021
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