Individual
CODY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
2900 S DIXON RD, KOKOMO, IN 46902-2997
(765) 210-1284
Mailing address
2900 S DIXON RD, KOKOMO, IN 46902-2997
(765) 210-1284
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-144171
IN
106S00000X
Behavior Technician
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BACB633685
BEHAVIOR ANALYST CERTIFICATION BOARD
IN
Enumeration date
12/16/2020
Last updated
01/09/2025
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