Provider Demographics
NPI:1760109680
Name:REGISTER, CHARLSIE (RBT)
Entity Type:Individual
Prefix:MRS
First Name:CHARLSIE
Middle Name:
Last Name:REGISTER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 RONDA ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32534-9654
Mailing Address - Country:US
Mailing Address - Phone:850-288-1928
Mailing Address - Fax:
Practice Address - Street 1:4891 GLOVER LN
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4556
Practice Address - Country:US
Practice Address - Phone:850-626-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-240265106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician