Individual
MR. CHARLES HUGH MCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3637 MISSION AVE BLDG B, CARMICHAEL, CA 95608
(916) 485-4175
Mailing address
3637 MISSION AVE BLDG B, CARMICHAEL, CA 95608-2946
(916) 485-4175
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/26/2007
Last updated
06/19/2019
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