Individual
CAROLANN ARDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RAS
Contact information
Practice address
1001 BROADWAY, SUITE 201, JACKSON, CA 95642
(209) 223-6412
(209) 223-0920
Mailing address
1001 BROADWAY, SUITE 201, JACKSON, CA 95642
(209) 223-6412
(209) 223-0920
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RASIRI-D0509150826
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RASIRI-D0509150826
ADDICTION SPECIALIST
CA
Enumeration date
05/02/2007
Last updated
07/08/2007
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