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MR. JAMES EDWARD CHARLES L.S.A.A.

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1841524204

Individual Registrant:
MR. JAMES EDWARD CHARLES L.S.A.A.
Gender: M
Sole Proprietor

Location and contact information for practice:
HC 64 BOX 23C  CHIMAYO, NM 87522-9715 US
Tel: 505-351-2447  Fax: 505-351-2446

Contact information for business:
HC 64 BOX 23C  CHIMAYO, NM 87522-9715 US
Tel: 505-351-2447  Fax: 505-351-2446

Registration Information:
NPI: 1841524204
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
NM006253

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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