Individual
MR. ANTOINE J CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
6614 SHALLOWFORD RD STE 250, LEWISVILLE, NC 27023-9305
(336) 945-0137
(336) 945-0137
Mailing address
4731 SEMINOLE CT, WINSTON SALEM, NC 27127-9432
(336) 782-7640
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23019
NC
Other
Enumeration date
08/11/2018
Last updated
08/11/2018
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