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NPI Code Detail

MEDICARE: PORSHA JOHNSON

MEDICARE: PORSHA 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

General Provider Information

NPI Number : 1376485029
Entity Type Code : Individual
Provider Name (Legal Business Name) : PORSHA JOHNSON
Provider Business Mailing Address
First Line : 30 KANDLEWOOD DR
Second Line :
City : SAVANNAH
State : GA
Zip : 31406-5843
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 105 GRAND CENTRAL BLVD STE 101
Second Line :
City : POOLER
State : GA
Zip : 31322-4146
Country : US
Telephone Number : 912-244-3305
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ PORSHA JOHNSON ” Practice Location

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