Provider Demographics
NPI:1114466273
Name:CHARITE, GUETCHINE
Entity Type:Individual
Prefix:
First Name:GUETCHINE
Middle Name:
Last Name:CHARITE
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 1:142 EA SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-5553
Mailing Address - Country:US
Mailing Address - Phone:863-464-0541
Mailing Address - Fax:
Practice Address - Street 1:142 EA SMITH AVE
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:FL
Practice Address - Zip Code:33852-5553
Practice Address - Country:US
Practice Address - Phone:863-464-0541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst