Provider Demographics
NPI:1811661366
Name:LAMONACA, XANATHEA MARIA
Entity type:Individual
Prefix:MISS
First Name:XANATHEA
Middle Name:MARIA
Last Name:LAMONACA
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 1:1210 ALDERSGATE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6606
Mailing Address - Country:US
Mailing Address - Phone:501-574-3053
Mailing Address - Fax:
Practice Address - Street 1:2311 ENERGY DRIVE
Practice Address - Street 2:BUILDING #9
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502
Practice Address - Country:US
Practice Address - Phone:919-589-4523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-50496103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst