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Individual
RENE CARRILLO
Active
Individual
RENE CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
67694
CA
1041C0700X
Clinical Social Worker
Primary
102805
CA
Other
Enumeration date
04/04/2011
Last updated
03/17/2022
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