Individual
CAROL LYNN MICHAELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1235 MCHENRY AVE STE A&B, MODESTO, CA 95350-5370
(209) 527-4597
(209) 527-4599
Mailing address
650 COMSTOCK LN, MANTECA, CA 95336-8530
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/16/2017
Last updated
04/07/2018
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