Provider Demographics
NPI:1205419868
Name:GARAY, LINDA MARIA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIA
Last Name:GARAY
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 1:11338 CYPRESS LEAF DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5873
Mailing Address - Country:US
Mailing Address - Phone:954-383-9692
Mailing Address - Fax:
Practice Address - Street 1:11338 CYPRESS LEAF DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-5873
Practice Address - Country:US
Practice Address - Phone:954-383-9692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-03
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-164323106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician