Provider Demographics
NPI:1417475351
Name:BERLANT, LYLA SHAINA (BCBA)
Entity Type:Individual
Prefix:
First Name:LYLA
Middle Name:SHAINA
Last Name:BERLANT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 IRONSTONE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-8025
Mailing Address - Country:US
Mailing Address - Phone:407-252-7268
Mailing Address - Fax:
Practice Address - Street 1:924 DELANEY AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1246
Practice Address - Country:US
Practice Address - Phone:407-247-5165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-18-29229103K00000X
0-16-6981103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst