Provider Demographics
NPI:1366544207
Name:MAHR, CAROL A (MS)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:MAHR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7509 MADISON AVE
Mailing Address - Street 2:BLDG. B, STE. 106
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7467
Mailing Address - Country:US
Mailing Address - Phone:916-539-7591
Mailing Address - Fax:916-560-3116
Practice Address - Street 1:7509 MADISON AVE
Practice Address - Street 2:BLDG. B, STE. 106
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7467
Practice Address - Country:US
Practice Address - Phone:916-539-7591
Practice Address - Fax:916-560-3116
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40540106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist