Individual
MRS. JOSIE LYNN CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
8344 HALL RD STE 209, UTICA, MI 48317-5554
(586) 286-5870
(586) 286-5834
Mailing address
7159 MELDRUM RD, IRA, MI 48023-2429
(586) 804-1207
(586) 286-5834
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
636200902
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
636200902
STATE LICENSE
MI
Enumeration date
02/06/2024
Last updated
02/06/2024
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