Individual
CAROLYN LEE MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5201 S VERMONT AVE, LOS ANGELES, CA 90037-3527
(323) 781-3026
Mailing address
114 E HILLCREST BLVD, 1, INGLEWOOD, CA 90301-2418
(310) 491-8765
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1006031525
CA
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/22/2011
Last updated
05/01/2019
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