Provider Demographics
NPI:1740640663
Name:BITTINGER, KATHLEEN MARIE (RBT)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:BITTINGER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:MARIE
Other - Last Name:EDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8314 SW 196TH COURT RD
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34432-3598
Mailing Address - Country:US
Mailing Address - Phone:703-409-8734
Mailing Address - Fax:
Practice Address - Street 1:2102 SW 20TH PL
Practice Address - Street 2:SUITE 302
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0861
Practice Address - Country:US
Practice Address - Phone:352-332-8588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist