Provider Demographics
NPI:1609387547
Name:LAPLACE, DALIANA
Entity Type:Individual
Prefix:
First Name:DALIANA
Middle Name:
Last Name:LAPLACE
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 1:16336 SW 97TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-5932
Mailing Address - Country:US
Mailing Address - Phone:786-274-0885
Mailing Address - Fax:
Practice Address - Street 1:16336 SW 97TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-5932
Practice Address - Country:US
Practice Address - Phone:786-274-0885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2021-03-15
Deactivation Date:2020-06-08
Deactivation Code:
Reactivation Date:2021-03-15
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician