Healthcare Provider Details

I. General information

NPI: 1760318570
Provider Name (Legal Business Name): COURTNEY STITH RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 AMERICAN LEGION RD STE A
CHESAPEAKE VA
23321-5653
US

IV. Provider business mailing address

3105 AMERICAN LEGION RD STE A
CHESAPEAKE VA
23321-5653
US

V. Phone/Fax

Practice location:
  • Phone: 757-572-2973
  • Fax: 757-282-2421
Mailing address:
  • Phone: 757-572-2973
  • Fax: 757-282-2421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-546148
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: