Provider Demographics
NPI:1588470371
Name:TOWNSEND, CHARLENE SUZANNE (LMT, MMP)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:SUZANNE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W NORTH LOOP BLVD UNIT B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-1918
Mailing Address - Country:US
Mailing Address - Phone:512-815-7516
Mailing Address - Fax:
Practice Address - Street 1:2404 S F ST STE C
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-7591
Practice Address - Country:US
Practice Address - Phone:956-622-3009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLMT108555225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist