Individual
CARESS COUSINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1235 MCHENRY AVE STE A&B, MODESTO, CA 95350-5370
(209) 527-4597
Mailing address
1235 MCHENRY AVE STE A&B, MODESTO, CA 95350-5370
(209) 527-4597
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
710599
CA
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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