Provider Demographics
NPI:1356073985
Name:GRINAN LOBAINA, ERLEY
Entity Type:Individual
Prefix:
First Name:ERLEY
Middle Name:
Last Name:GRINAN LOBAINA
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 1:2721 NE 6TH LN
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33334-2507
Mailing Address - Country:US
Mailing Address - Phone:954-275-5447
Mailing Address - Fax:
Practice Address - Street 1:2721 NE 6TH LN
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33334-2507
Practice Address - Country:US
Practice Address - Phone:954-275-5447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician