Provider Demographics
NPI:1841176831
Name:HERRAN LABRADOR, JOHNER JOSE
Entity type:Individual
Prefix:
First Name:JOHNER
Middle Name:JOSE
Last Name:HERRAN LABRADOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 NEW GARDEN RD APT 1808
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-1737
Mailing Address - Country:US
Mailing Address - Phone:786-655-3262
Mailing Address - Fax:
Practice Address - Street 1:2205 NEW GARDEN RD APT 1808
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-1737
Practice Address - Country:US
Practice Address - Phone:786-655-3262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-25-439766106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician