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Individual

MS. SANDRA GAYLE MANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CADDTP

Contact information

Practice address
714 N ANAHEIM BLVD, ANAHEIM, CA 92805-2651
(714) 776-6090
Mailing address
25761 LE PARC UNIT 33, LAKE FOREST, CA 92630-5936
(949) 951-0851

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
11/14/2006
Last updated
07/08/2007
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