| NPI | 1609656602 |
|---|---|
| Former Name | ALICIA NICOLE CHARLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN277064) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2024-12-23 |