Individual
CHARLESTON MATALDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1208 WESTPORT BEACH WAY UNIT B, WEST FARGO, ND 58078-8857
(701) 317-5128
Mailing address
1208 WESTPORT BEACH WAY UNIT B, WEST FARGO, ND 58078-8857
(701) 317-5128
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
03/06/2021
Last updated
03/06/2021
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