Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 5319-C | NV |
N | 1041C0700X | Clinical Social Worker | X-06140 | NM |
NPI | 1003062027 |
---|---|
Provider Name | Ms. Angela Michelle Charter |
First Address | Sparks, NV 89434-3483 |
Second Address | Sparks, NV 89434-3483 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2008 |
Last Update Date | 04/09/2009 |