Provider Demographics
NPI:1932983608
Name:GIRALDO DUQUE, LAURA I (RBT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:I
Last Name:GIRALDO DUQUE
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 1:2231 DISCOVERY CIR W
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BCH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1036
Mailing Address - Country:US
Mailing Address - Phone:754-271-3377
Mailing Address - Fax:
Practice Address - Street 1:2231 DISCOVERY CIR W
Practice Address - Street 2:
Practice Address - City:DEERFIELD BCH
Practice Address - State:FL
Practice Address - Zip Code:33442-1036
Practice Address - Country:US
Practice Address - Phone:754-271-3377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-289240106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician