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General NPI Number Information
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NPI Number | 1235095795
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Entity Type | Individual
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Provider Name | LAURA DE SOUZA
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Gender | Female
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 2233 S HIGHLAND AVE APT 1001
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City | LOMBARD
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State | IL
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Zip | 60148-5331
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Country | US
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Telephone | 954-696-0279
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Fax |
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Provider Business Mailing Address
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Address Line | 550 SE 2ND AVE APT G2
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-7516
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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