Provider Demographics
NPI:1568095636
Name:DUPREE, PALMER LECHANDLE JR
Entity Type:Individual
Prefix:
First Name:PALMER
Middle Name:LECHANDLE
Last Name:DUPREE
Suffix:JR
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 1:3795 BURNAGE HALL RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-5608
Mailing Address - Country:US
Mailing Address - Phone:704-773-3498
Mailing Address - Fax:
Practice Address - Street 1:3795 BURNAGE HALL RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-5608
Practice Address - Country:US
Practice Address - Phone:704-773-3498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician