Individual
CLARENCE WILLIAM TEDROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC-CAS
Contact information
Practice address
5362 LEMEE LN, MARIPOSA, CA 95338-9556
(209) 966-2000
Mailing address
PO BOX 99, MARIPOSA, CA 95338-0099
(209) 966-2000
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
C034610415
CA
Other
Enumeration date
11/01/2017
Last updated
11/01/2017
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