Individual
MS. MERLE VIOLA CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
480 E 13TH ST, MERCED, CA 95340-6214
(209) 381-6876
Mailing address
2185 ORTA CORTE, CHOWCHILLA, CA 93610-9462
(559) 665-2287
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT12122
CA
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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