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General NPI Number Information
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NPI Number | 1720896319
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Entity Type | Individual
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Provider Name | NAVAYAH JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 12/27/2024
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 3435 W CRAIG RD STE B
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City | N LAS VEGAS
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State | NV
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Zip | 89032-5116
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Country | US
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Telephone | 702-207-4458
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Fax |
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Provider Business Mailing Address
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Address Line | 5965 PALMILLA ST UNIT 7
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City | N LAS VEGAS
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State | NV
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Zip | 89031-4146
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Country | US
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Telephone | 909-212-1096
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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 | NV
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