Tisha Yolanda Johnson
Behavior Technician in Jacksonville, FL. Individual provider (NPI-1).
NPI number1083242556
StatusActive
Last updated in NPPESMar 31, 2020
Details
- NPI
- 1083242556
- Entity type
- Individual (NPI-1)
- Name
- Ms. Tisha Yolanda Johnson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 31, 2020
- Certification date
- Mar 31, 2020
- Last updated
- Mar 31, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
4624 Park StJacksonville, FL 32205-7327
Phone 904-503-0131
Mailing address
4429 Melvin Cir EJacksonville, FL 32210-4731
Phone 904-862-0372
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