Provider Demographics
NPI:1568197903
Name:STILLWELL, LINDA (RBT)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:STILLWELL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7552 NAVARRE PKWY UNIT 12
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-7312
Mailing Address - Country:US
Mailing Address - Phone:850-860-4050
Mailing Address - Fax:850-739-7615
Practice Address - Street 1:7552 NAVARRE PKWY UNIT 12
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7312
Practice Address - Country:US
Practice Address - Phone:850-860-4050
Practice Address - Fax:850-739-7615
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-1683-427877106S00000X
FLRBT-22-225733106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician