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General NPI Number Information
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NPI Number | 1629306972
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Entity Type | Individual
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Provider Name | ROBIN LANE DEHAINAUT MA, BCBA
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Gender | Female
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Dates
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Enumeration Date | 11/25/2009
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 18946 NORTH DALE MABRY
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City | LUTZ
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State | FL
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Zip | 33548
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Country | US
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Telephone | 727-241-0246
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Fax | 727-240-4720
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Provider Business Mailing Address
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Address Line | 1353 LOTUS PATH
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City | CLEARWATER
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State | FL
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Zip | 33756
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Country | US
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Telephone | 727-241-0246
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Fax | 727-240-4720
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-09-5814
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License Number State | FL
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