Individual
LOURDINE CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TSHH
Contact information
Practice address
3140B E TREMONT AVE, BRONX, NY 10461-5706
(917) 660-0007
Mailing address
PO BOX 394, BRONX, NY 10460-0242
(917) 660-0007
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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