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General NPI Number Information
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NPI Number | 1598576076
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Entity Type | Individual
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Provider Name | JOANN CHARLES
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Gender | Female
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 900 S SHACKLEFORD RD
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City | LITTLE ROCK
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State | AR
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Zip | 72211-3817
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Country | US
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Telephone | 785-825-0541
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Fax | 785-825-0062
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Provider Business Mailing Address
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Address Line | 110 W OTIS AVE
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City | SALINA
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State | KS
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Zip | 67401-8713
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Country | US
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Telephone | 785-825-0541
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Fax | 785-825-0062
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 11483-M
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License Number State | AR
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