Individual
BRENDA N CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
704 FIELDCREST DR, DALLAS, GA 30132-2110
(470) 800-5239
Mailing address
225 CEDAR HILL ST STE 200, MARLBOROUGH, MA 01752-5900
(470) 800-3259
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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