Provider Demographics
NPI:1376036053
Name:TURCOTTE, DEVAN
Entity Type:Individual
Prefix:
First Name:DEVAN
Middle Name:
Last Name:TURCOTTE
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 1:1243 EASTON RD STE 103
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-3801
Mailing Address - Country:US
Mailing Address - Phone:267-217-3585
Mailing Address - Fax:267-657-1341
Practice Address - Street 1:1243 EASTON RD STE 103
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-3801
Practice Address - Country:US
Practice Address - Phone:267-217-3585
Practice Address - Fax:267-657-1341
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH006146103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1038005930002Medicaid