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Individual

LISA CHARLIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
634 10TH AVE W, DICKINSON, ND 58601-4749
(701) 690-6299
Mailing address
634 10TH AVE W, DICKINSON, ND 58601-4749
(701) 690-6299

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
376J00000X
Homemaker
Primary

Other

Enumeration date
10/15/2020
Last updated
10/15/2020
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