Individual
DIANA LAQUERRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1696 WEST BROAD STREET, COOKEVILLE, TN 38501
(931) 263-8908
Mailing address
1696 WEST BROAD STREET, COOKEVILLE, TN 38501
(931) 263-8908
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-452965
TN
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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