Provider Demographics
NPI:1336838101
Name:VAITKEVICIUS, ROBERT ADAM (RBT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ADAM
Last Name:VAITKEVICIUS
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 RYDER RD APT 309
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-1054
Mailing Address - Country:US
Mailing Address - Phone:248-346-6599
Mailing Address - Fax:
Practice Address - Street 1:423 RYDER RD APT 309
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-1054
Practice Address - Country:US
Practice Address - Phone:248-346-6599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician