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NPI Code Detail

MEDICARE: TIMOTHY JOHNSON II

MEDICARE: TIMOTHY JOHNSON II
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
1373H00000XDay Training/Habilitation Specialist5534VA

General Provider Information

NPI Number : 1588436810
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY JOHNSON II
Provider Business Mailing Address
First Line : 116 LANDMARK SQ STE 104
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23452-6872
Country : US
Telephone Number : 757-477-3165
Fax Number :
Provider Business Practice Location Address
First Line : 116 LANDMARK SQ STE 104
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23452-6872
Country : US
Telephone Number : 757-477-3165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2023
Last Update Date : 10/30/2023

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Directions to “ TIMOTHY JOHNSON II ” Practice Location

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