Individual
CHARLES M-INIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC-A
Contact information
Practice address
720 E PARK BLVD, PLANO, TX 75074-5450
(469) 342-3468
Mailing address
720 E PARK BLVD, PLANO, TX 75074-5450
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
89609
TX
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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