Kelly-Clark, Antoinette

Kelly-Clark, Antoinette is an individual health care provider with primary practice located at 171 Water Tank Rd , Ruston LA 71270-8550. She recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as her primary health care specialty. Kelly-Clark, Antoinette can be contacted via phone (318) 548-7242.

Contact Information

Primary practice address
171 Water Tank Rd Ruston LA 71270-8550
Phone: (318) 548-7242
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X

Profile Details

NPI number 1417638800
LBN Legal business name Kelly-Clark, Antoinette
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2023
Last updated Jul 27th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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