Individual
CHARLES SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2003 LINCOLN DR W STE C, MARLTON, NJ 08053-1529
(856) 596-8007
Mailing address
125 ESTATES RD, PINE HILL, NJ 08021-6512
(856) 669-8138
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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