Most Relevant Information
Provider Data
| NPI Number: | 1003688995 |
| Provider Name: | BRENDA N CHARLES |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/24/2023 |
| Last Updated: | 10/24/2023 |
Provider Practice Location
704 FIELDCREST DR
DALLAS
GA
301322110
Practice Location Phone/Fax
| Phone: | 4708005239 |
| Fax: |
Provider Mailing Location
225 CEDAR HILL ST STE 200
MARLBOROUGH
MA
017525900
Provider Mailing Phone/Fax
| Phone: | 4708003259 |
| Fax: |