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Individual

CHARLES RICHARD PANTHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW

Contact information

Practice address
30 PENNSYLVANIA AVE, CANTON, NC 28716
(828) 538-1383
Mailing address
30 PENNSYLVANIA AVE, CANTON, NC 28716
(828) 538-1383

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004383
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
142GN
BC BS OF NC
NC
05
6106086
NC
Enumeration date
11/29/2006
Last updated
07/11/2014
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