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Individual

CAROLINE ARLENE WALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD-I, CHLC

Contact information

Practice address
1129 MARSH ST, SAN LUIS OBISPO, CA 93401-3323
(805) 543-7969
Mailing address
1026 HENRY AVE APT G, SANTA MARIA, CA 93455-8406
(612) 247-8443

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
11/17/2017
Last updated
11/17/2017
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