Healthcare Provider Details

I. General information

NPI: 1841139516
Provider Name (Legal Business Name): KIARRA LASHELLE JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 PAUL EELLS DR
NORTH LITTLE ROCK AR
72113-7608
US

IV. Provider business mailing address

14 FAIR OAKS DR
LITTLE ROCK AR
72204-3512
US

V. Phone/Fax

Practice location:
  • Phone: 501-234-0950
  • Fax:
Mailing address:
  • Phone: 501-850-4594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: