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Individual

MR. CHARLES JAMES THREATT III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPCC, PPS

Contact information

Practice address
1277 ORCHARD GLEN CIR, ENCINITAS, CA 92024-5661
(510) 255-0335
Mailing address
1277 ORCHARD GLEN CIR, ENCINITAS, CA 92024-5661
(510) 255-0335

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
15870
CA

Other

Enumeration date
05/31/2019
Last updated
09/09/2024
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