Individual
MR. JONATHAN SIAKE JOHNSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14056 E VASSAR AVE APT C-206, AURORA, CO 80014
(719) 679-7679
Mailing address
14056 E VASSAR AVE APT C-206, AURORA, CO 80014-2387
(719) 679-7679
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
NONE
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
CO
Enumeration date
06/13/2022
Last updated
06/13/2022
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