Provider Demographics
NPI:1114815180
Name:REDDIX, OLIVIA GRACE (RBT)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:GRACE
Last Name:REDDIX
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:PO BOX 203
Mailing Address - Street 2:
Mailing Address - City:SCOTTS HILL
Mailing Address - State:TN
Mailing Address - Zip Code:38374-0203
Mailing Address - Country:US
Mailing Address - Phone:731-733-4040
Mailing Address - Fax:
Practice Address - Street 1:759 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-1738
Practice Address - Country:US
Practice Address - Phone:731-968-0017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-24-332873106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician