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Individual
MR. CORY SHANE MANN
Active
Individual
MR. CORY SHANE MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CI33360721
CA
376J00000X
Homemaker
—
—
Other
Enumeration date
03/09/2021
Last updated
01/28/2022
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