Healthcare Provider Details

I. General information

NPI: 1477260180
Provider Name (Legal Business Name): ALAYJAH JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8230 LEESBURG PIKE STE 740
VIENNA VA
22182-2641
US

IV. Provider business mailing address

9280 E PATRICK HENRY RD
ASHLAND VA
23005-7422
US

V. Phone/Fax

Practice location:
  • Phone: 877-504-4141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: