Healthcare Provider Details

I. General information

NPI: 1275137788
Provider Name (Legal Business Name): PAIGE BARBARA JOHNSON RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2020
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 3 MILE RD NW STE C
GRAND RAPIDS MI
49544-8251
US

IV. Provider business mailing address

1550 3 MILE RD NW STE C
GRAND RAPIDS MI
49544-8251
US

V. Phone/Fax

Practice location:
  • Phone: 616-840-8807
  • Fax: 616-840-9684
Mailing address:
  • Phone: 616-840-8807
  • Fax: 616-840-9684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401003403
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: