Individual
JACOB W CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
411 MILL ST, RENO, NV 89502-1025
(775) 351-7057
Mailing address
710 HUNTER LAKE DR, RENO, NV 89509-1216
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
GF-125403151
NV
Other
Enumeration date
02/27/2011
Last updated
02/27/2011
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