Individual provider · NPI-1

Quantrell Devon Fortune, M. Ed BCBA

Behavior Analyst · Lithonia, GA

NPI number1710559299
StatusActive
Last updated in NPPESJul 14, 2021

Details

NPI
1710559299
Entity type
Individual (NPI-1)
Name
Quantrell Devon Fortune
Credential
M. Ed BCBA
Sex
Male
Sole proprietor
No
Enumeration date
Jul 14, 2021
Certification date
Jul 11, 2021
Last updated
Jul 14, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103K00000X Behavior Analyst––Yes

Practice location

1031 Palmer Rd
Lithonia, GA 30058-9083

Phone 770-547-4085

Mailing address

1031 Palmer Rd
Lithonia, GA 30058-9083

Phone 770-547-4085

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Behavior Analyst providers in Lithonia, GA