Provider Demographics
NPI:1437994738
Name:LASTRE, ADRIANA (RBT)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:LASTRE
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 1:5657 MANGO RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33413-1851
Mailing Address - Country:US
Mailing Address - Phone:561-644-7299
Mailing Address - Fax:
Practice Address - Street 1:5657 MANGO RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33413-1851
Practice Address - Country:US
Practice Address - Phone:561-644-7299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician