Individual
THOMAS L CHARLES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
108 E NORTH ST, FRIENDSHIP, WI 53934-9443
(608) 339-4511
(608) 339-4593
Mailing address
108 E NORTH ST, FRIENDSHIP, WI 53934-9443
(608) 339-4511
(608) 339-4593
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4207-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39587400
—
WI
Enumeration date
10/04/2005
Last updated
07/09/2007
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