Healthcare Provider Details

I. General information

NPI: 1932061652
Provider Name (Legal Business Name): COURTNEY PRETTYMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 E MIRACLE STRIP PKWY STE 503
MARY ESTHER FL
32569-1991
US

IV. Provider business mailing address

124 E MIRACLE STRIP PKWY STE 503
MARY ESTHER FL
32569-1991
US

V. Phone/Fax

Practice location:
  • Phone: 844-729-2242
  • Fax:
Mailing address:
  • Phone: 844-729-2242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT25495622
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: