Provider Demographics
NPI:1720221823
Name:BALDWIN, CHARLES JR (BCABA)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:BALDWIN
Suffix:JR
Gender:M
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9709 DEAN ACRE CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-6543
Mailing Address - Country:US
Mailing Address - Phone:407-580-2795
Mailing Address - Fax:
Practice Address - Street 1:9709 DEAN ACRE CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-6543
Practice Address - Country:US
Practice Address - Phone:407-580-2795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0020424103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst