IndividualActive
Antionette Clark
NPI 1588943161 · Mental Health Counselor · Vicksburg, MS
Provider details
- NPI number
- 1588943161
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
3444 Wisconsin Ave
Vicksburg, MS 39180-5331
Phone: (601) 638-0031
Approximate (ZIP-level) locationGet directions
Mailing address
3444 Wisconsin Ave
Vicksburg, MS 39180-5331
Registry dates
- Enumerated
- 2011-08-12
- Last updated
- 2011-08-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.