Individual
JOHANNA TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1131 HEKAU ST, AIEA, HI 96701-4222
(425) 870-9311
Mailing address
1131 HEKAU ST, AIEA, HI 96701-4222
(425) 870-3111
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
344
HI
106S00000X
Behavior Technician
RBT-17-34576
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004871
—
HI
Enumeration date
06/12/2017
Last updated
04/14/2023
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