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Individual
DR. AMANDA REANE JOHNSON
Active
Individual
DR. AMANDA REANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1063923340
AZ
103K00000X
Behavior Analyst
1063923340
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003008277
—
AZ
05
—
103K00000X
—
AZ
01
—
1063923340
BEHAVIORAL ANALYSIS
—
Enumeration date
03/10/2021
Last updated
06/03/2021
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