MEDICARE: REBECCA VITA 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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1306657812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA VITA RBT

Provider Business Mailing Address
First Line	:	8063 MADISON AVE STE 544
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-6001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8063 MADISON AVE STE 544
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-6001
Country	:	US
Telephone Number	:	928-223-3508
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2025
Last Update Date	:	02/16/2026

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Directions to “ REBECCA VITA RBT” Practice Location

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