Provider Demographics
NPI:1447526744
Name:MENARD, CAROLYN RENEE
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:RENEE
Last Name:MENARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:RENEE
Other - Last Name:MENARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2166 OSHEA WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-9603
Mailing Address - Country:US
Mailing Address - Phone:530-304-7632
Mailing Address - Fax:
Practice Address - Street 1:2166 OSHEA WAY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-9603
Practice Address - Country:US
Practice Address - Phone:530-304-7632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator