Ethan C Mandelkern
NPI #1023224623 in Mount Shasta, California
Provider Information
- NPI Number
- 1023224623
- Entity Type
- Individual
- Name
- Ethan C Mandelkern
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- May 14, 2007
- Last Updated
- Aug 12, 2024
Practice Location
- Address
- 419 CHESTNUT ST
- Address 2
- SUITE #2
- City
- Mount Shasta
- State
- California
- ZIP Code
- 96067-2918
- Phone
- (530) 918-8348
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
| Social Worker - Clinical — Clinical |
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