Provider Demographics
NPI:1497355416
Name:LANCASTER, DEVONTA MARKEICE (RBT)
Entity Type:Individual
Prefix:MR
First Name:DEVONTA
Middle Name:MARKEICE
Last Name:LANCASTER
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 SATELLITE BLVD APT 701
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4018
Mailing Address - Country:US
Mailing Address - Phone:404-807-7236
Mailing Address - Fax:
Practice Address - Street 1:2200 SATELLITE BLVD APT 701
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4018
Practice Address - Country:US
Practice Address - Phone:404-807-7236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician