Provider Demographics
NPI:1417296674
Name:CHARTIER, JEREMY
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:CHARTIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 N FEDERAL HWY
Mailing Address - Street 2:BUTTERFLY EFFECTS LLC, SUITE 2 SOUTH
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6519
Mailing Address - Country:US
Mailing Address - Phone:888-880-9270
Mailing Address - Fax:954-342-0273
Practice Address - Street 1:21752 PACIFIC COAST HWY
Practice Address - Street 2:SPC 11A
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-7609
Practice Address - Country:US
Practice Address - Phone:714-785-4861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist