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NPI Code Detail

MEDICARE: XENA JOHNSON

MEDICARE: XENA JOHNSON
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1194683342
Entity Type Code : Individual
Provider Name (Legal Business Name) : XENA JOHNSON
Provider Business Mailing Address
First Line : 10545 BLAIR RD STE 100
Second Line :
City : MINT HILL
State : NC
Zip : 28227-2800
Country : US
Telephone Number : 704-780-4271
Fax Number :
Provider Business Practice Location Address
First Line : 10545 BLAIR RD STE 100
Second Line :
City : MINT HILL
State : NC
Zip : 28227-2800
Country : US
Telephone Number : 704-780-4271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2026
Last Update Date : 01/14/2026

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Directions to “ XENA JOHNSON ” Practice Location

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