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NPI Code Detail

MEDICARE: EVELYN JOHNSON

MEDICARE: EVELYN 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 : 1508719485
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVELYN JOHNSON
Provider Business Mailing Address
First Line : 6013 S REDWOOD RD
Second Line :
City : TAYLORSVILLE
State : UT
Zip : 84123-5220
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5558 S 1900 W
Second Line :
City : TAYLORSVILLE
State : UT
Zip : 84129-9007
Country : US
Telephone Number : 801-255-5131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2026
Last Update Date : 02/19/2026

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Directions to “ EVELYN JOHNSON ” Practice Location

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