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Individual

KAYLA JEAN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5800 MONTPELIER DR, WILLIAMSBURG, VA 23188-8120
(720) 339-6418
Mailing address
5800 MONTPELIER DR, WILLIAMSBURG, VA 23188-8120
(720) 339-6418

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-251019
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RBT-22-251019
BACB
VA
Enumeration date
12/28/2022
Last updated
12/28/2022
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