MEDICARE: MONIQUE 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
1	103K00000X	Behavior Analyst
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1427282227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE JOHNSON

Provider Business Mailing Address
First Line	:	PO BOX 13243
Second Line	:
City	:	READING
State	:	PA
Zip	:	19612-3243
Country	:	US
Telephone Number	:	610-741-5728
Fax Number	:

Provider Business Practice Location Address
First Line	:	4641 POTTSVILLE PIKE
Second Line	:
City	:	READING
State	:	PA
Zip	:	19605-9707
Country	:	US
Telephone Number	:	610-741-5728
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2009
Last Update Date	:	10/26/2022

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Directions to “ MONIQUE JOHNSON ” Practice Location

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