Individual
KATRENA JOELLE LACOSTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2544 S ADAMS ST, ARLINGTON, VA 22206-2806
(765) 412-5174
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(185) 583-2672
(772) 675-9100
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-313839
VA
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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