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Organization
LAKELAND BEHAVIOR SERVICES, LLC
Active
Organization
LAKELAND BEHAVIOR SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS A YANCE (ADMIN)
(786) 602-0904
Entity
Organization
Contact information
Practice address
3745 HILL ST, LAKELAND, FL 33812-4338
(786) 602-0904
Mailing address
3745 HILL ST, LAKELAND, FL 33812-4338
(786) 602-0904
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
06/27/2022
Last updated
06/27/2022
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