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NPI Code Detail

MEDICARE: MS. JOHNNA RENEA SOLER M.A., B.C.B.A.

MEDICARE: MS. JOHNNA RENEA SOLER M.A., B.C.B.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1093019283
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JOHNNA RENEA SOLER M.A., B.C.B.A.
Provider Business Mailing Address
First Line : 1409 W CARROLL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60607-1105
Country : US
Telephone Number : 312-733-0883
Fax Number :
Provider Business Practice Location Address
First Line : 1409 W CARROLL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60607-1105
Country : US
Telephone Number : 312-733-0883
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2011
Last Update Date : 09/16/2022

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