Provider Demographics
NPI:1063869063
Name:LIVINGSTON, SOMMER (RBT)
Entity type:Individual
Prefix:MRS
First Name:SOMMER
Middle Name:
Last Name:LIVINGSTON
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 1:1018 RADCLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-3132
Mailing Address - Country:US
Mailing Address - Phone:850-814-8805
Mailing Address - Fax:
Practice Address - Street 1:1018 RADCLIFF AVE
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-3132
Practice Address - Country:US
Practice Address - Phone:850-814-8805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst