Individual
MR. LARRY S CHARLES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
795 WHITE HORSE PIKE, SUITE B, HADDON TOWNSHIP, NJ 08107-1264
(215) 207-4089
Mailing address
795 WHITE HORSE PIKE, SUITE B, HADDON TOWNSHIP, NJ 08107-1264
(215) 207-4089
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
376K00000X
Nurse's Aide
Primary
NA200011057
NJ
Other
Enumeration date
05/04/2014
Last updated
05/04/2014
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