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Individual

CAROLYN SUZANNE GILLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MHS II

Contact information

Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8700
Mailing address
2220 DOUGLAS RD, STOCKTON, CA 95207-3331
(209) 468-8700

Taxonomy

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

Other

Enumeration date
04/13/2007
Last updated
07/08/2007
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