Provider Demographics
NPI:1487333795
Name:EGUIA, CHASITY YVONNE
Entity type:Individual
Prefix:
First Name:CHASITY
Middle Name:YVONNE
Last Name:EGUIA
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 1:7340 COLDSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2204
Mailing Address - Country:US
Mailing Address - Phone:609-372-0965
Mailing Address - Fax:
Practice Address - Street 1:5861 SW 18TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-5914
Practice Address - Country:US
Practice Address - Phone:609-372-0965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician