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1104300623
CHARNELLE WILLIS
PORT ST LUCIE, FL
NPI
1104300623
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-09-20
Last Update Date
2018-09-20
Business Address
CHARNELLE WILLIS
525 NW LAKE WHITNEY PL
PORT ST LUCIE, FL 34986-1605
Phone number: 772-337-8164
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Mailing Address
CHARNELLE WILLIS
4977 NW FOXWORTH AVE
PORT ST LUCIE, FL 34983-2302
Phone number: 954-815-6241
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