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NPI 1306530712

NPI 1306530712 : MICHAEL LAGUERRE : TITUSVILLE, FL

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General NPI Number Information
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    NPI Number           |    1306530712
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL LAGUERRE
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/07/2023
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    Last Update Date     |    04/21/2025
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Provider Practice Location Address
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    Address Line         |    3880 CATALINA ST 
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    City                 |    TITUSVILLE
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    State                |    FL
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    Zip                  |    32796-2211
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    Country              |    US
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    Telephone            |    321-346-8450
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2105 ONETA CT 
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32818-5322
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    Country              |    US
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    Telephone            |    321-315-4872
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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       |    RBT-23-277524
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    License Number State |    FL
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Taxonomy #2
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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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