Individual
THERESA B JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
116 BLUEBIRD DR, BAILEY, CO 80421-2004
(404) 643-3621
Mailing address
116 BLUEBIRD DR, BAILEY, CO 80421-2004
(404) 643-3621
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000141643
—
CO
Enumeration date
11/06/2013
Last updated
10/05/2025
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