Provider Demographics
NPI:1326445701
Name:GUILLAUME, CHARLINE
Entity type:Individual
Prefix:
First Name:CHARLINE
Middle Name:
Last Name:GUILLAUME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 SE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4443
Mailing Address - Country:US
Mailing Address - Phone:561-537-9385
Mailing Address - Fax:
Practice Address - Street 1:127 SE 6TH ST
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4443
Practice Address - Country:US
Practice Address - Phone:561-537-9385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2024-05-28
Deactivation Date:2018-05-14
Deactivation Code:
Reactivation Date:2024-05-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health