Individual
CHARLENE WHITE BYNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DOCTORAL STUDENT HCA
Contact information
Practice address
1213 BALZAR AVE, LAS VEGAS, NV 89106-2207
(702) 810-4830
(702) 255-7766
Mailing address
408 ELDORADO HILLS CT, LAS VEGAS, NV 89110-5646
(702) 810-4830
(702) 255-7766
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5464TLF-1
NV
103K00000X
Behavior Analyst
5061AGC-1
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251S0000X
—
NV
Enumeration date
01/10/2011
Last updated
01/10/2011
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