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NPI Code Detail

MEDICARE: BRANDON M ROUTT RBT

MEDICARE: BRANDON M ROUTT 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
1106S00000XBehavior TechnicianRBT-23-260339

General Provider Information

NPI Number : 1467138651
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON M ROUTT RBT
Provider Business Mailing Address
First Line : 2464 FORTUNE DR STE 195
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-4261
Country : US
Telephone Number : 859-899-9200
Fax Number :
Provider Business Practice Location Address
First Line : 2464 FORTUNE DR STE 195
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-4261
Country : US
Telephone Number : 859-899-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2023
Last Update Date : 01/15/2025

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Directions to “ BRANDON M ROUTT RBT” Practice Location

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