Healthcare Provider Details

I. General information

NPI: 1861347825
Provider Name (Legal Business Name): MS. KATHY BILLETTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12823 SOLOLA WAY
TRINITY FL
34655-7246
US

IV. Provider business mailing address

7614 FARMLAWN DR
PORT RICHEY FL
34668-4007
US

V. Phone/Fax

Practice location:
  • Phone: 727-534-6042
  • Fax:
Mailing address:
  • Phone: 727-226-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-01-22
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: