Individual
JAMIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
630 S RANCHO DR, STE A, LAS VEGAS, NV 89106-4873
(702) 564-2453
(702) 527-5353
Mailing address
8405 SEA GLEN DR, LAS VEGAS, NV 89128-7180
(702) 812-9381
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LABA0006
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-16-21516
BOARD CERTIFIED BEHAVIOR ANALYST
NV
05
—
1033564588
—
NV
Enumeration date
05/03/2016
Last updated
02/26/2018
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