Individual
MISS CAROLINA LYNN STORMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RATD
Contact information
Practice address
1405 11TH ST, MODESTO, CA 95354-0748
(209) 284-0970
(209) 284-0971
Mailing address
1030 CALIFORNIA AVE # CA, MODESTO, CA 95351-2102
(209) 550-7352
(209) 521-7001
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1240900117
CA
Other
Enumeration date
02/01/2018
Last updated
02/01/2018
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