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NPI Code Detail

MEDICARE: CODY JOHNSON RBT

MEDICARE: CODY JOHNSON RBT
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 TechnicianIN
2106S00000XBehavior TechnicianRBT-20-144171IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1BACB633685OTHERINBEHAVIOR ANALYST CERTIFICATION BOARD

General Provider Information

NPI Number : 1568058303
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODY JOHNSON RBT
Provider Business Mailing Address
First Line : 2900 S DIXON RD
Second Line :
City : KOKOMO
State : IN
Zip : 46902-2997
Country : US
Telephone Number : 765-210-1284
Fax Number :
Provider Business Practice Location Address
First Line : 2900 S DIXON RD
Second Line :
City : KOKOMO
State : IN
Zip : 46902-2997
Country : US
Telephone Number : 765-210-1284
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2020
Last Update Date : 01/09/2025

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Directions to “ CODY JOHNSON RBT” Practice Location

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