Provider Demographics
NPI:1013639285
Name:BILLITER, KENYA MARIE (RBT)
Entity type:Individual
Prefix:
First Name:KENYA
Middle Name:MARIE
Last Name:BILLITER
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 1:373 FRIENDLY HILL RD
Mailing Address - Street 2:
Mailing Address - City:FRIENDLY
Mailing Address - State:WV
Mailing Address - Zip Code:26146-7408
Mailing Address - Country:US
Mailing Address - Phone:304-815-3154
Mailing Address - Fax:
Practice Address - Street 1:1402 COLEGATE DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1330
Practice Address - Country:US
Practice Address - Phone:740-371-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRBT-22-231914106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician