Provider Demographics
NPI:1861089682
Name:CHARLOT, BRITTANY TONI (BCBA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:TONI
Last Name:CHARLOT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:TONI
Other - Last Name:GONZALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:620 N ROBINSON DR
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:TX
Mailing Address - Zip Code:76706-5312
Mailing Address - Country:US
Mailing Address - Phone:254-732-2262
Mailing Address - Fax:
Practice Address - Street 1:6824 LOGUE LN
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-7241
Practice Address - Country:US
Practice Address - Phone:254-327-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 106S00000X
TX5730103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician