Individual
HEATHER CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2135 HIGHWAY 1185, LOUISA, KY 41230-7968
(606) 826-0257
(606) 826-0206
Mailing address
PO BOX 686, LOUISA, KY 41230-0686
(606) 826-0257
(606) 826-0206
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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