Individual
MRS. NATALIA MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
935B SPRING ST, PLACERVILLE, CA 95667-4523
(530) 621-6218
Mailing address
935B SPRING ST, PLACERVILLE, CA 95667-4523
(530) 621-6218
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
097004267
CA
Other
Enumeration date
03/28/2009
Last updated
03/28/2009
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