Alissa Meredith Johnson

Individual provider Active NPI Behavior Technician · Callahan, FL

NPI 1619703196 · NPPES record last updated Sep 11, 2024

Key facts

NPI
1619703196
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
450061 State Road 200 Unit 2
Callahan, FL 32011-3842
Phone
(904) 886-3228
NPI assigned
Sep 11, 2024
Sex
Female
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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

450061 State Road 200 Unit 2
Callahan, FL 32011-3842

Mailing address

450061 State Road 200 Unit 2
Callahan, FL 32011-3842

Other providers in Callahan, FL

All providers in Callahan, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.