Individual
CAROLLYNE WINGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
731 S LINCOLN ST, SANTA MARIA, CA 93458-6107
(805) 346-8185
(805) 346-8656
Mailing address
475 GOLDEN WEST PL, ARROYO GRANDE, CA 93420-3722
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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