MEDICARE: DANIELLE NICOLE 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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1952193500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE NICOLE JOHNSON

Provider Business Mailing Address
First Line	:	7500 SAN FELIPE ST STE 990
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-1708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	32502 TAMINA RD
Second Line	:
City	:	MAGNOLIA
State	:	TX
Zip	:	77354-7450
Country	:	US
Telephone Number	:	936-206-5158
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2025
Last Update Date	:	05/20/2025

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Directions to “ DANIELLE NICOLE JOHNSON ” Practice Location

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