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General NPI Number Information
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NPI Number | 1710590930
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Entity Type | Individual
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Provider Name | CAITLIN ANN JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 08/27/2020
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 420 HAWTHORNE LN
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City | CHARLOTTE
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State | NC
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Zip | 28204-2312
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Country | US
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Telephone | 704-780-4271
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Fax |
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Provider Business Mailing Address
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Address Line | 126 GLENVILLE AVE APT 1
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City | ALLSTON
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State | MA
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Zip | 02134-3307
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Country | US
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Telephone | 901-491-0607
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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