Provider Demographics
NPI:1548572993
Name:LEVINS, JOHNNA (BCBA)
Entity Type:Individual
Prefix:
First Name:JOHNNA
Middle Name:
Last Name:LEVINS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 BURNETTS WAY
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8166
Mailing Address - Country:US
Mailing Address - Phone:757-934-6470
Mailing Address - Fax:757-934-6471
Practice Address - Street 1:156 BURNETTS WAY
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8166
Practice Address - Country:US
Practice Address - Phone:757-934-6470
Practice Address - Fax:757-934-6471
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-10-6731174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist