Provider Demographics
NPI:1710858428
Name:HUNTLEY, SANTANNA M (RBT)
Entity type:Individual
Prefix:
First Name:SANTANNA
Middle Name:M
Last Name:HUNTLEY
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 1:720 S 14TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-5724
Mailing Address - Country:US
Mailing Address - Phone:870-636-3590
Mailing Address - Fax:
Practice Address - Street 1:914 LACKEY RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AR
Practice Address - Zip Code:72364-5016
Practice Address - Country:US
Practice Address - Phone:870-636-3590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-24-376951106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty