Provider Demographics
NPI:1043036635
Name:CHARLES, AMARI MARIE
Entity type:Individual
Prefix:
First Name:AMARI
Middle Name:MARIE
Last Name:CHARLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 JIM KNIGHT RD SE
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30121-5551
Mailing Address - Country:US
Mailing Address - Phone:678-780-1867
Mailing Address - Fax:
Practice Address - Street 1:231 JIM KNIGHT RD SE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30121-5551
Practice Address - Country:US
Practice Address - Phone:678-780-1867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician