Individual
JACQUELINE ELIZABETH CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
215 N 2ND ST STE 109, RIVER FALLS, WI 54022-3707
(715) 629-7047
Mailing address
200 QUALITY AVE S, LAKELAND, MN 55043-9656
(307) 575-5257
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7581-125
WI
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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