Individual
LISA JOANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5423 SPOKED WHEEL DR, COLORADO SPRINGS, CO 80923-8741
(719) 641-7240
Mailing address
4903 VILLA CIR, COLORADO SPRINGS, CO 80918-2216
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437321189
TRICARE (HEALTHNET)
CO
Enumeration date
12/15/2017
Last updated
03/30/2022
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