Provider Demographics
NPI:1477058204
Name:GARACHE, LEYLA JACQUELINE (RBT)
Entity Type:Individual
Prefix:MRS
First Name:LEYLA
Middle Name:JACQUELINE
Last Name:GARACHE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12545 SOPHIAMARIE LOOP
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7168
Mailing Address - Country:US
Mailing Address - Phone:407-371-8035
Mailing Address - Fax:
Practice Address - Street 1:12545 SOPHIAMARIE LOOP
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7168
Practice Address - Country:US
Practice Address - Phone:407-371-8035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-25
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No252Y00000XAgenciesEarly Intervention Provider Agency