Provider Demographics
NPI:1710713987
Name:LARA GUILARTE, HANY LAIDEN (RBT-24-372314)
Entity type:Individual
Prefix:MS
First Name:HANY
Middle Name:LAIDEN
Last Name:LARA GUILARTE
Suffix:
Gender:F
Credentials:RBT-24-372314
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 JOHNS AVE
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33972-1811
Mailing Address - Country:US
Mailing Address - Phone:786-793-5917
Mailing Address - Fax:
Practice Address - Street 1:1721 JOHNS AVE
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33972-1811
Practice Address - Country:US
Practice Address - Phone:786-793-5917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24372314106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician