Individual
MS. CARLY ROSE WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APCC
Contact information
Practice address
2788 EAST BERRY PRIVADO, UNIT 90, ONTARIO, CA 91761-2740
(909) 378-5894
Mailing address
1171 E ALOSTA AVE # 344, AZUSA, CA 91702-2740
(909) 378-5894
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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