Provider Demographics
NPI:1942768312
Name:PALMER, DEVONNA (RBT)
Entity Type:Individual
Prefix:
First Name:DEVONNA
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 E DESERT INN RD STE 210
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3625
Mailing Address - Country:US
Mailing Address - Phone:702-538-8420
Mailing Address - Fax:
Practice Address - Street 1:2755 E DESERT INN RD STE 210
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3625
Practice Address - Country:US
Practice Address - Phone:702-538-8420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-19-80143106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician