Provider Demographics
NPI:1558788737
Name:JOHNSTON, TONIA (BCBA)
Entity Type:Individual
Prefix:MS
First Name:TONIA
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:TONIA
Other - Middle Name:MARIE
Other - Last Name:MCCORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2351 MARIE WAY
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-8593
Mailing Address - Country:US
Mailing Address - Phone:360-720-8899
Mailing Address - Fax:
Practice Address - Street 1:1001 LAURENCE AVE STE E
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-2980
Practice Address - Country:US
Practice Address - Phone:517-750-4777
Practice Address - Fax:517-782-4717
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WABACB264972103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor