Individual
CAROL ARCHIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
269 S MARIPOSA AVE, LOS ANGELES, CA 90004-5407
(213) 639-2696
(213) 389-1987
Mailing address
4421 W 63RD ST, LOS ANGELES, CA 90043-3513
(323) 898-1160
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
01/18/2008
Last updated
01/18/2008
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