Naomi Riddlebaugh

Individual provider Active NPI Behavior Technician · Sumterville, FL

NPI 1801549043 · NPPES record last updated Jan 28, 2022

Key facts

NPI
1801549043
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-21-188750 (FL)
Practice address
2210 CR 528
Sumterville, FL 33585-5214
Phone
(352) 314-3760
Fax
(352) 314-2909
NPI assigned
Jan 28, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-21-188750FLMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician
Group: 193200000X MULTI-SPECIALTY GROUP
106S00000X RBT-21-188750 FL Yes

Addresses

Primary practice location

2210 CR 528
Sumterville, FL 33585-5214

Mailing address

1650 W Main St Ste 1
Leesburg, FL 34748-2842
Phone (352) 314-3760

Other identifiers

IdentifierTypeStateIssuer
112210100MedicaidFL

Other providers in Sumterville, FL

All providers in Sumterville, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.