Individual
ANTIONETTE MARIE CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2035 FAIRMONT DR, SAN LEANDRO, CA 94578-1088
(510) 346-7836
Mailing address
2035 FAIRMONT DR, SAN LEANDRO, CA 94578-1088
(510) 346-7836
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/17/2018
Last updated
05/17/2018
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