Johnny E. Burgos
Individual provider Active NPI Behavior Technician · Blacklick, OH
NPI 1033780218 · NPPES record last updated Jul 8, 2021
Key facts
- NPI
- 1033780218
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 1582 N Waggoner Rd
Blacklick, OH 43004-8669 - Phone
- (303) 989-8169
- NPI assigned
- Jul 8, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
1582 N Waggoner Rd
Blacklick, OH 43004-8669
Mailing address
1582 N Waggoner Rd
Blacklick, OH 43004-8669
Other providers in Blacklick, OH
- Brian Brown
- Earlena Brown
- Klyn Brown
- Lauren Brubaker
- Rylie Bruce
- Deborah Byrd
- Glen Caldwell
- Teresa Caldwell
- Vanessa Calhoun
- Micrita Calloway
All providers in Blacklick, OH · Behavior Technician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.