Individual
DR. CHARLES R CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-0297
(859) 323-5500
Mailing address
800 ROSE ST, D104, LEXINGTON, KY 40536-0297
(859) 323-5500
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0656
KY
Other
Enumeration date
10/04/2006
Last updated
03/13/2012
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