Provider Demographics
NPI:1295422715
Name:EUGENE, CHELSEA (RBT)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:EUGENE
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 HOLLYWOOD BLVD STE PHE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6760
Mailing Address - Country:US
Mailing Address - Phone:954-822-4175
Mailing Address - Fax:
Practice Address - Street 1:3900 HOLLYWOOD BLVD STE PHE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6760
Practice Address - Country:US
Practice Address - Phone:954-822-4175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician