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NPI Code Detail

MEDICARE: MS. TONIA JOHNSTON BCBA

MEDICARE: MS. TONIA JOHNSTON BCBA
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
1101Y00000XCounselor
2103K00000XBehavior AnalystBACB264972WA

General Provider Information

NPI Number : 1558788737
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TONIA JOHNSTON BCBA
Provider Business Mailing Address
First Line : 2351 MARIE WAY
Second Line :
City : OAK HARBOR
State : WA
Zip : 98277-8593
Country : US
Telephone Number : 360-720-8899
Fax Number :
Provider Business Practice Location Address
First Line : 1001 LAURENCE AVE STE E
Second Line :
City : JACKSON
State : MI
Zip : 49202-2980
Country : US
Telephone Number : 517-750-4777
Fax Number : 517-782-4717
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2014
Last Update Date : 07/07/2016

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