Individual
MR. JAMES EDWARD CHARLES SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.S.A.A.
Contact information
Practice address
HC 64 BOX 23C, CHIMAYO, NM 87522-9715
(505) 351-2447
(505) 351-2446
Mailing address
HC 64 BOX 23C, CHIMAYO, NM 87522-9715
(505) 351-2447
(505) 351-2446
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
006253
NM
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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