Provider Demographics
NPI:1679286702
Name:D'ANTONIO GIRALDO, LORI ANNE
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANNE
Last Name:D'ANTONIO GIRALDO
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 1:6334 7TH AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3517
Mailing Address - Country:US
Mailing Address - Phone:347-636-1750
Mailing Address - Fax:
Practice Address - Street 1:6334 7TH AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-3517
Practice Address - Country:US
Practice Address - Phone:347-636-1750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician