Individual
ROBERT LAURAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
1900 DENNIS FLAT ROAD, DEETH, NV 89823-0057
(775) 340-5943
Mailing address
PO BOX 57, DEETH, NV 89823-0057
(775) 340-5943
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBAT042222
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LBAT042222
STATE LICENSE
NV
Enumeration date
09/13/2011
Last updated
01/27/2016
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