Individual provider · Type 1 NPI
Theresa Mamie Charles I
Addiction (Substance Use Disorder) Counselor · Groton, CT
NPI number
1255769576
Active
Practice location
542 Longhill Road
Groton, CT 06340
Mailing address
542 Long Hill Rd
Groton, CT 06340-4108
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 060886125 (CT) |
| Mental Health Counselor | 101YM0800X | 060886125 |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1255769576
Theresa Mamie Charles I's National Provider Identifier is 1255769576, issued on Oct 23, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Groton, CT. The record was last updated on Oct 23, 2013.