Healthcare Provider Details

I. General information

NPI: 1962347906
Provider Name (Legal Business Name): KARLEY CLINTON MA, CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

668 OLD SALT RD
SUMRALL MS
39482-4232
US

IV. Provider business mailing address

609 COX AVE
HATTIESBURG MS
39402-2106
US

V. Phone/Fax

Practice location:
  • Phone: 601-270-6968
  • Fax: 601-336-5255
Mailing address:
  • Phone: 601-270-0065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: