Individual
ANDREW JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2989 BROADMOOR VALLEY RD, COLORADO SPRINGS, CO 80906-4403
(719) 575-1316
Mailing address
2989 BROADMOOR VALLEY RD, COLORADO SPRINGS, CO 80906-4403
(719) 233-6230
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-48227
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26-475-3045
TRICARE
—
Enumeration date
02/02/2018
Last updated
02/02/2018
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