Individual
WILLIAM CODY DANIEL CHARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC-R, CRM II
Contact information
Practice address
1333 NW 9TH ST, PRINEVILLE, OR 97754-1482
(541) 447-2631
Mailing address
139 S MAIN ST, PRINEVILLE, OR 97754-2744
(541) 206-5589
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
23-CRM-II-0154
OR
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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