Provider Information for 1184098949
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Mr. CHARLES WILSON JONES LMFT
Sex: Male
NPI: 1184098949
Last Updated: 2015-11-17
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1184098949 | ||||||||
| Enumeration Date | 2015-11-17 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 525 PORTLAND AVE MC 963 MINNEAPOLIS, MN 55415-1533 United States Phone: 612-348-2233 | Fax:612-677-6357 | ||||||||
| Primary Practice Address | 525 PORTLAND AVE MC 963 MINNEAPOLIS, MN 55415-1533 United States Phone: 612-348-2233 | Fax:612-677-6357 | ||||||||
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