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General NPI Number Information
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NPI Number | 1790593143
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Entity Type | Individual
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Provider Name | LANITTA LONZETTE JOSEPH RBT
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Gender | Female
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 104 GLEN OAK BLVD STE 120
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-6421
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Country | US
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Telephone | 615-637-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 661 PACE ST
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City | GALLATIN
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State | TN
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Zip | 37066-2167
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Country | US
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Telephone | 615-319-8719
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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