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Destiny Clark
NPI 1700578010 · on the registry since 2023 · sole proprietor
Practice
- Address
- 6811 Old Canton Rd Apt 3305
Ridgeland, MS 39157 - Phone
- (769) 231-7366
Registry record
- Primary taxonomy
- 335E00000X
335E00000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-05-24
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi