Most Relevant Information
Provider Data
| NPI Number: | 1003305426 |
| Provider Name: | LARA DABAIBEH |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | 17-38456 |
Most Important Dates
| Enumeration Date: | 05/02/2018 |
| Last Updated: | 05/02/2018 |
Provider Practice Location
17 CALEDON CT STE B
GREENVILLE
SC
296153170
Practice Location Phone/Fax
| Phone: | 8646312084 |
| Fax: |
Provider Mailing Location
2580 LIN DO CT
SUMTER
SC
291501832
Provider Mailing Phone/Fax
| Phone: | 8039054427 |
| Fax: | 8039054431 |