Provider Demographics
NPI:1871386128
Name:REEVES, STEPHANIE (RBT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:REEVES
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 1:211 FOREST TRACE
Mailing Address - Street 2:STEPHIEC08@GMAIL.COM
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-3011
Mailing Address - Country:US
Mailing Address - Phone:470-851-5750
Mailing Address - Fax:
Practice Address - Street 1:3005 HOLLY SPRINGS PKWY STE A
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30115-2342
Practice Address - Country:US
Practice Address - Phone:413-526-7222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-22-228935106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician