Individual
MS. SANDRA P CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ICADC, CADCII, CCS
Contact information
Practice address
404 ROSEINE DR, WARNER ROBINS, GA 31088-8686
(850) 774-8646
Mailing address
404 ROSEINE DR, WARNER ROBINS, GA 31088-8686
(850) 774-8646
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
083
GA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
439
GA
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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