Organization
CHARLES CARLISE EDD PSYCHOLOGIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES GASPER CARLISE EDD (PSYCHOLOGIST)
(602) 622-2933
Entity
Organization
Contact information
Practice address
2345 E THOMAS RD, SUITE 295, PHOENIX, AZ 85016-7848
(602) 622-2933
(602) 957-3063
Mailing address
2345 E THOMAS RD, SUITE 295, PHOENIX, AZ 85016-7848
(602) 622-2933
(602) 957-3063
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
3229
AZ
Other
Enumeration date
08/20/2007
Last updated
08/20/2007
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