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Contact Information

COLLETTE CHARLES
4460 S HIGHLAND DR STE 230
SALT LAKE CITY, UT84124
 Phone: 888-949-4864
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for COLLETTE CHARLES · (Female)

NPI # 1316465743
Status Active
Credentials
Entity Individual
Enumeration date 09/06/2017
Last updated 05/25/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 10831011-3502
  • UT Medicaid 1316465743
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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