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Individual
MILES HAAKON JOHNSON
Active
Individual
MILES HAAKON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-18-49272
TRICARE
AK
Enumeration date
02/06/2018
Last updated
02/06/2018
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