Individual
SHASHI CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 SAN ILDEFONSO RD APT C11, LOS ALAMOS, NM 87544-4201
(615) 596-4380
Mailing address
650 SAN ILDEFONSO RD APT C11, LOS ALAMOS, NM 87544-4201
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/28/2016
Last updated
10/21/2016
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