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NPI Code Detail

MEDICARE: PRISCILLA JOHNSON

MEDICARE: PRISCILLA JOHNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194440982
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRISCILLA JOHNSON
Provider Business Mailing Address
First Line : 745 ORIENTA AVE STE 1011
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32701-5675
Country : US
Telephone Number : 877-823-4283
Fax Number : 352-332-8589
Provider Business Practice Location Address
First Line : 50 S BELCHER RD STE 103
Second Line :
City : CLEARWATER
State : FL
Zip : 33765-3948
Country : US
Telephone Number : 877-823-4283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2022
Last Update Date : 10/05/2022

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Directions to “ PRISCILLA JOHNSON ” Practice Location

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