Provider Demographics
NPI:1336954320
Name:EPPS, LAQUANDA (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:
First Name:LAQUANDA
Middle Name:
Last Name:EPPS
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 PARK PLACE DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-7693
Mailing Address - Country:US
Mailing Address - Phone:919-605-4140
Mailing Address - Fax:
Practice Address - Street 1:139 PARK PLACE DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7693
Practice Address - Country:US
Practice Address - Phone:919-605-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-08
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician