Individual
CARL DAHLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1297 W HOBSONWAY, BLYTHE, CA 92225-1423
(760) 921-5000
Mailing address
9826 18TH AVE, BLYTHE, CA 92225-9229
(909) 381-3774
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
CICA01710819
CA
Other
Enumeration date
01/23/2017
Last updated
11/27/2024
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