| Doctor Name: | MR. CHARLES ALAN PERINE |
| NPI Number: | 1255646170 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | AU.D. |
| License Number: | |
| Business Practice Address: | 368 Bielby Rd Suite 140 Ludlow Hill Preofessional Bldg Lawrenceburg, IN - 47025 |
| Business Phone Number: | 8125375510 |
| Business Fax Number: | 8125374138 |
| Mailing Address: | 40 N. Grand Ave. Suite 103, Head & Neck Surgery Assoc. Psc FORT THOMAS |
| State: | KY |
| Postal Code: | 41075 |
| Phone Number: | 8597814900 |
| Fax Number: | 8595723039 |
| NPI Enumeration Date: | 08/16/2010 |
| NPI Last Update Date: | 03/14/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |