Individual
CAROL LOUINE MANSFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RI
Contact information
Practice address
14709 LAKESHORE DRIVE, CLEARLAKE, CA 95422
(707) 995-3235
Mailing address
1830 LINCOLN AVE, PO BOX 1164, CALISTOGA, CA 94515-1115
(707) 942-1179
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RI-M0701032214
CA
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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