Provider Demographics
NPI:1043908684
Name:MCLESTER, QUATAVIA
Entity Type:Individual
Prefix:
First Name:QUATAVIA
Middle Name:
Last Name:MCLESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 197601
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-7601
Mailing Address - Country:US
Mailing Address - Phone:470-751-4642
Mailing Address - Fax:
Practice Address - Street 1:1040 CAMBRIDGE SQ STE A
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1800
Practice Address - Country:US
Practice Address - Phone:770-743-9048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst