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Individual

CHARLOTTE STANTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
830 B ST, SAN RAFAEL, CA 94901-3003
(415) 459-5843
Mailing address
7462 CALDER AVE, SEBASTOPOL, CA 95472-4356
(510) 207-0349

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/17/2014
Last updated
03/17/2014
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