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General NPI Number Information
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NPI Number | 1730484254
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Entity Type | Organization
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Legal Business Name | ANGIE CHARTER, LCSW, LLC
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Dates
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Enumeration Date | 01/13/2011
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 421 W PLUMB LN SUITE A-5
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City | RENO
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State | NV
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Zip | 89509-3766
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Country | US
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Telephone | 775-338-3786
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Fax | 775-453-1132
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Provider Business Mailing Address
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Address Line | 421 W PLUMB LN SUITE A-5
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City | RENO
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State | NV
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Zip | 89509-3766
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Country | US
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Telephone | 775-338-3786
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Fax | 775-354-1132
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Authorized Official
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Title or Position | OWNER
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Name | MS. ANGIE CHARTER I
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Credential | LCSW
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Telephone | 775-338-3786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5319-C
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License Number State | NV
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