Individual
AMETRA CARROL-CASTANEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-3013
(309) 779-2078
Mailing address
2950 VALLEY DR, ROCK ISLAND, IL 61201-6939
(309) 373-1202
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
28786
IL
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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