Individual
LISA A CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.ED.
Contact information
Practice address
1751 RIVER BEND DR, ALLEGAN, MI 49010-8227
(269) 512-5178
(269) 645-5930
Mailing address
41521 W 11 MILE RD, NOVI, MI 48375-1803
(804) 447-8049
(804) 447-8049
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6451023963
MI
103T00000X
Psychologist
PPS-0601360
VA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
04/02/2009
Last updated
03/02/2026
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