MEDICARE: KIERRA 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
1	106S00000X	Behavior Technician	RBT-26-534009	CO

General Provider Information

NPI Number	:	1548197643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIERRA JOHNSON

Provider Business Mailing Address
First Line	:	1330 QUAIL LAKE LOOP
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4651
Country	:	US
Telephone Number	:	719-540-2108
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 QUAIL LAKE LOOP
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4651
Country	:	US
Telephone Number	:	719-540-2108
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “ KIERRA JOHNSON ” Practice Location

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