Individual
DAVINE THELMA LASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1807 SOUTHGATE ST, DURHAM, NC 27703-2035
(302) 898-0561
Mailing address
1807 SOUTHGATE ST, DURHAM, NC 27703-2035
(302) 898-0561
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/03/2021
Last updated
12/03/2021
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