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ALICE CHARLTON
Clinical >> Social Worker >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1821218157
Individual Registrant: ALICE CHARLTON
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
970 6TH AVE BETHEL, AK 99559-0652 US
Tel: 907-543-4633 Fax: --
Tel: 907-543-4633 Fax: --
Contact information for business:
PO BOX 652 BETHEL, AK 99559-0652 US
Tel: 907-543-4633 Fax: --
Tel: 907-543-4633 Fax: --
Registration Information:
NPI: 1821218157
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1041C0700X | Behavioral Health & Social Service Providers Social Worker Clinical |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| MH0150 | AK | 05 |
