Roneisha C Johnson
Individual provider Active NPI Behavior Technician · Dolton, IL
NPI 1780404178 · NPPES record last updated Oct 11, 2024
Key facts
- NPI
- 1780404178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 15204 Harper Ave
Dolton, IL 60419-3112 - Phone
- (312) 835-3868
- NPI assigned
- Oct 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
15204 Harper Ave
Dolton, IL 60419-3112
Mailing address
15204 Harper Ave
Dolton, IL 60419-3112
Phone (312) 835-3868
Other providers in Dolton, IL
- Lisa Gibson Jackson
- Jaroslaus T Iwanetz MD SC
- Michelle Jenkins
- Nikkita Chennille Johnson-Neealy
- Quintella Johnson
- Tinesha Denise Johnson
- Yvette Johnson
- Chunita Jones
- Malherbe Joey Joseph
- Journey for Healthier Living
All providers in Dolton, IL · Behavior Technician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2024. 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.