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NPI Code Detail

MEDICARE: DONTE JOHNS

MEDICARE: DONTE JOHNS
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 : 1497266571
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONTE JOHNS
Provider Business Mailing Address
First Line : 3656 N RANCHO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-3172
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3656 N RANCHO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-3172
Country : US
Telephone Number : 702-680-9107
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2017
Last Update Date : 10/17/2017

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Directions to “ DONTE JOHNS ” Practice Location

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