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NPI Code Detail

MEDICARE: HEATHER JOHNSON

MEDICARE: HEATHER 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 : 1801722442
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER JOHNSON
Provider Business Mailing Address
First Line : 29566 NORTHWESTERN HWY STE 100
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48034-1036
Country : US
Telephone Number : 833-328-8476
Fax Number :
Provider Business Practice Location Address
First Line : 29566 NORTHWESTERN HWY STE 100
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48034-1036
Country : US
Telephone Number : 833-328-8476
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2026
Last Update Date : 06/22/2026

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Directions to “ HEATHER JOHNSON ” Practice Location

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