Provider Demographics
NPI:1790593143
Name:JOSEPH, LANITTA LONZETTE (RBT)
Entity type:Individual
Prefix:
First Name:LANITTA
Middle Name:LONZETTE
Last Name:JOSEPH
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 1:661 PACE ST
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-2167
Mailing Address - Country:US
Mailing Address - Phone:615-319-8719
Mailing Address - Fax:
Practice Address - Street 1:104 GLEN OAK BLVD STE 120
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6421
Practice Address - Country:US
Practice Address - Phone:615-637-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician