Provider Demographics
NPI:1366284929
Name:LORENZO, LUZ SELEYNIE (RBT)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:SELEYNIE
Last Name:LORENZO
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 1:650 ACADEMY DR APT 104
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-8650
Mailing Address - Country:US
Mailing Address - Phone:939-777-1804
Mailing Address - Fax:
Practice Address - Street 1:1633 E VINE ST STE 213
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-3705
Practice Address - Country:US
Practice Address - Phone:689-200-4783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-353271106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician