Individual
MR. CHARLES VERNON HUNGATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RASI
Contact information
Practice address
1496 N BEALE RD, MARYSVILLE, CA 95901-6205
(530) 749-8640
Mailing address
618 ELM ST APT 2, MARYSVILLE, CA 95901-5562
(530) 671-6961
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RIH1107212339
CA
Other
Enumeration date
10/07/2011
Last updated
10/07/2011
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