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NPI Code Detail

MEDICARE: TRISTEENA RECKLING RBT

MEDICARE: TRISTEENA RECKLING 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
1171M00000XCase Manager/Care Coordinator
2106S00000XBehavior TechnicianRBT-20-109602

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659910891
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRISTEENA RECKLING RBT
Provider Business Mailing Address
First Line : 7941 CASTLEWAY DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-1953
Country : US
Telephone Number : 937-371-5724
Fax Number :
Provider Business Practice Location Address
First Line : 77 E WOODBURY DR STE 110
Second Line :
City : DAYTON
State : OH
Zip : 45415-2853
Country : US
Telephone Number : 937-373-7848
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2020
Last Update Date : 02/28/2025

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Directions to “ TRISTEENA RECKLING RBT” Practice Location

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