Individual
MISS CHARLENE MARIE TEBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
81 PLANTATION ST, WORCESTER, MA 01604-3069
(508) 770-0511
Mailing address
40 DAYTON ST, APARTMENT 1R, WORCESTER, MA 01609-2188
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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