Individual
CARMEN LOU MIZERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1235 MCHENRY AVE, MODESTO, CA 95350-5370
(707) 676-0539
Mailing address
1235 MCHENRY AVE, MODESTO, CA 95350-5370
(707) 676-0539
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12855
CA
Other
Enumeration date
07/03/2024
Last updated
07/31/2024
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