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NPI Code Detail

MEDICARE: ERINMARIE JOHNSON

MEDICARE: ERINMARIE 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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1861817124
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERINMARIE JOHNSON
Provider Business Mailing Address
First Line : 2709 DEAN RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-5138
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3771 SAN JOSE PL STE 22
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257-2439
Country : US
Telephone Number : 904-928-0112
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2014
Last Update Date : 02/24/2014

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Directions to “ ERINMARIE JOHNSON ” Practice Location

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