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NPI Code Detail

MEDICARE: REBECCA ANN JOHNSON BCABA

MEDICARE:   REBECCA ANN JOHNSON  BCABA
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 Analyst0-11-4103

General Provider Information

NPI Number : 1932497427
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA ANN JOHNSON BCABA
Provider Business Mailing Address
First Line : 1602 WILLIAM ST
Second Line : UPPER FLOOR
City : FREDERICKSBURG
State : VA
Zip : 22401-5549
Country : US
Telephone Number : 540-368-8087
Fax Number : 540-368-8059
Provider Business Practice Location Address
First Line : 1602 WILLIAM ST
Second Line : UPPER FLOOR
City : FREDERICKSBURG
State : VA
Zip : 22401-5549
Country : US
Telephone Number : 540-368-8087
Fax Number : 540-368-8059
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2011
Last Update Date : 07/18/2011

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