Individual
CAROL MARIE SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
323 N PRAIRIE AVE, INGLEWOOD, CA 90301-4502
(310) 846-2100
Mailing address
24535 TOWN CENTER DR APT 6304, VALENCIA, CA 91355-0802
(818) 326-7302
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1109221736
CA
Other
Enumeration date
10/16/2014
Last updated
10/16/2014
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