Provider Demographics
NPI:1740710359
Name:WINSLOW, CHARLENE MARIE
Entity type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:MARIE
Last Name:WINSLOW
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 1:2570 TECHNICAL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6107
Mailing Address - Country:US
Mailing Address - Phone:937-847-8750
Mailing Address - Fax:937-847-8753
Practice Address - Street 1:2570 TECHNICAL DRIVE
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342
Practice Address - Country:US
Practice Address - Phone:937-847-8750
Practice Address - Fax:937-847-8753
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician