Individual
CHARLENE WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2773 RICE AVE, SAN ANGELO, TX 76904-5806
(432) 270-0156
Mailing address
2773 RICE AVE, SAN ANGELO, TX 76904-5806
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
111680
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111680
TDLR
TX
Enumeration date
08/09/2022
Last updated
08/09/2022
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