Individual
CARLOS MACKALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
659 E CHESTNUT HILL RD, NEWARK, DE 19713-1827
(252) 438-4145
(252) 438-6405
Mailing address
2701 N 16TH ST STE 316, PHOENIX, AZ 85006-1266
(602) 636-5283
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1671
DE
Other
Enumeration date
08/09/2020
Last updated
09/01/2020
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