Provider Demographics
NPI:1134925308
Name:BUSTER, ROSETTA KAY (RBT)
Entity type:Individual
Prefix:MRS
First Name:ROSETTA
Middle Name:KAY
Last Name:BUSTER
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 N CENTENNIAL ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-2434
Mailing Address - Country:US
Mailing Address - Phone:317-835-1127
Mailing Address - Fax:
Practice Address - Street 1:2317 N CENTENNIAL ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-2434
Practice Address - Country:US
Practice Address - Phone:317-835-1127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-23-319558106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician