Individual
CHARLOTTE MARY MALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
292 ASHLEE AVE, MOUNTAIN HOUSE, CA 95391-1138
(209) 879-9570
Mailing address
292 ASHLEE AVE, MOUNTAIN HOUSE, CA 95391-1138
(209) 879-9570
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
05/03/2024
Last updated
10/24/2024
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