Healthcare Provider Details

I. General information

NPI: 1801723465
Provider Name (Legal Business Name): STEPHANIE CHAVEZ RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 VETERANS PKWY STE 11
COLUMBUS GA
31909-3514
US

IV. Provider business mailing address

1202 TECH BLVD STE 104
TAMPA FL
33619-7863
US

V. Phone/Fax

Practice location:
  • Phone: 706-221-8966
  • Fax: 706-705-9791
Mailing address:
  • Phone: 706-221-8966
  • Fax: 706-705-9791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: