Individual
ANNE ISABELLE CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
183 S ORANGE AVE, NEWARK, NJ 07103-2757
(973) 972-8300
Mailing address
183 SOUTH ORANGE AVE, NEWARK, NJ 07103
(973) 972-8300
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4144007
—
NJ
Enumeration date
10/09/2012
Last updated
10/09/2012
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