Individual
ALYSSA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
5526 N ACADEMY BLVD, COLORADO SPRINGS, CO 80918-3681
(720) 961-3764
Mailing address
5526 N ACADEMY BLVD STE 109, COLORADO SPRINGS, CO 80918-3688
(719) 301-5100
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1984734
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1984734
RBT
—
Enumeration date
05/09/2019
Last updated
06/02/2020
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