Individual
CHARLOTTE T CLOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-8470
(212) 923-2090
Mailing address
5 REVERE DR STE 102, NORTHBROOK, IL 60062-1567
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
170300000X
Genetic Counselor (M.S.)
Primary
—
—
Other
Enumeration date
10/03/2018
Last updated
12/02/2022
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