Individual
MICAYLA CHARITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1602 SE WALTON LAKES DR, PORT ST LUCIE, FL 34952-5107
(772) 985-5353
Mailing address
1602 SE WALTON LAKES DR, PORT ST LUCIE, FL 34952-5107
(772) 985-5353
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
RBT-15-09265
FL
Other
Enumeration date
02/01/2016
Last updated
02/01/2016
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