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NPI Code Detail

MEDICARE: ANNA LEE WITTE RBT

MEDICARE: ANNA LEE WITTE RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247200000XOther Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RBT-16-22748OTHERFLBEHAVIOR ANALYST CERTIFICATION BOARD

General Provider Information

NPI Number : 1154879286
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA LEE WITTE RBT
Provider Business Mailing Address
First Line : 171 ST HWY 83 N
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32433-7427
Country : US
Telephone Number : 850-468-0824
Fax Number :
Provider Business Practice Location Address
First Line : 171 ST HWY 83 N
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32433-7427
Country : US
Telephone Number : 850-468-0824
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2016
Last Update Date : 09/19/2016

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Directions to “ ANNA LEE WITTE RBT” Practice Location

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