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1023143955
CAROLLYNE WINGRAVE
SANTA MARIA, CA
NPI
1023143955
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Former Name
TAMARA ANN PATAGUE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-02-22
Last Update Date
2007-07-08
Business Address
-- CAROLLYNE WINGRAVE
731 S LINCOLN ST
SANTA MARIA, CA 93458-6107
Phone number: 805-346-8185
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Mailing Address
-- CAROLLYNE WINGRAVE
475 GOLDEN WEST PL
ARROYO GRANDE, CA 93420-3722
Phone number:
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