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NPI Code Detail

MEDICARE: TESSA JOHNSON

MEDICARE:   TESSA  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
1171M00000XCase Manager/Care Coordinator
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1780172262
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESSA JOHNSON
Provider Business Mailing Address
First Line : 7162 READING RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3838
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 26055 EMERY RD STE G
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-6211
Country : US
Telephone Number : 216-342-4445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2018
Last Update Date : 02/29/2024

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Directions to “ TESSA JOHNSON ” Practice Location

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