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NPI Code Detail

MEDICARE: BRITTNEY RENAE JOHNSON

MEDICARE: BRITTNEY RENAE 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
1101YA0400XAddiction (Substance Use Disorder) Counselor101YM0800XIN

General Provider Information

NPI Number : 1982026951
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTNEY RENAE JOHNSON
Provider Business Mailing Address
First Line : 3926 NEW VISION DR BLDG H
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1712
Country : US
Telephone Number : 260-266-1401
Fax Number :
Provider Business Practice Location Address
First Line : 1655 N CASS ST
Second Line :
City : WABASH
State : IN
Zip : 46992-9416
Country : US
Telephone Number : 260-569-2302
Fax Number : 260-569-2305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2014
Last Update Date : 12/08/2016

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Directions to “ BRITTNEY RENAE JOHNSON ” Practice Location

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