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NPI Code Detail

MEDICARE: MRS. ALEKSEI DREW JOHNSON MA, BCBA

MEDICARE: MRS. ALEKSEI DREW JOHNSON MA, BCBA
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
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1851864482
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALEKSEI DREW JOHNSON MA, BCBA
Provider Business Mailing Address
First Line : 1817 WELLSPRING AVE SE
Second Line :
City : RIO RANCHO
State : NM
Zip : 87124-4956
Country : US
Telephone Number : 505-828-3837
Fax Number :
Provider Business Practice Location Address
First Line : 1817 WELLSPRING AVE SE
Second Line :
City : RIO RANCHO
State : NM
Zip : 87124-4956
Country : US
Telephone Number : 505-828-3837
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2019
Last Update Date : 10/23/2024

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