Provider Demographics
NPI:1013783034
Name:SUTTEN, TIAUNNY NAOMI (RBT)
Entity Type:Individual
Prefix:MS
First Name:TIAUNNY
Middle Name:NAOMI
Last Name:SUTTEN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MISS
Other - First Name:TIAUNNY
Other - Middle Name:NAOMI
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10408 N LISTER CT
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64156-6338
Mailing Address - Country:US
Mailing Address - Phone:469-873-1738
Mailing Address - Fax:
Practice Address - Street 1:10408 N LISTER CT
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64156-6338
Practice Address - Country:US
Practice Address - Phone:816-536-6043
Practice Address - Fax:816-301-6576
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORBT-23-285502106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician