Individual
CHARLES LAMONTE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
380 FREEVILLE RD, FREEVILLE, NY 13068-9684
(607) 844-6492
Mailing address
380 FREEVILLE RD, FREEVILLE, NY 13068-9684
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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