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NPI Code Detail

MEDICARE: MITCH LANDRY RBT

MEDICARE: MITCH LANDRY 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-25-467641

General Provider Information

NPI Number : 1841137734
Entity Type Code : Individual
Provider Name (Legal Business Name) : MITCH LANDRY RBT
Provider Business Mailing Address
First Line : 16255 VENTURA BLVD STE 900
Second Line :
City : ENCINO
State : CA
Zip : 91436-2317
Country : US
Telephone Number : 803-335-0718
Fax Number :
Provider Business Practice Location Address
First Line : 197 PIEDMONT BLVD STE 111
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-1825
Country : US
Telephone Number : 803-335-0718
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2026
Last Update Date : 04/30/2026

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Directions to “ MITCH LANDRY RBT” Practice Location

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