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Individual
KAYLA JOHNSON
Active
Individual
KAYLA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT925
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BOC900903
ATHLETIC TRAINER
—
Enumeration date
08/11/2020
Last updated
08/11/2020
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