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NPI Code Detail

MEDICARE: RAYMONDE CHARLES

MEDICARE: RAYMONDE CHARLES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1740526979
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMONDE CHARLES
Provider Business Mailing Address
First Line : 2037 ESQUIRE RD
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23235-3523
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4100 PRICE CLUB BLVD
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23112-3379
Country : US
Telephone Number : 804-674-8888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2012
Last Update Date : 12/16/2012

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Directions to “ RAYMONDE CHARLES ” Practice Location

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