Provider Demographics
NPI:1003651308
Name:JOHNSON, RONEISHA LESHAY
Entity type:Individual
Prefix:
First Name:RONEISHA
Middle Name:LESHAY
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 OLD MONROVIA RD NW APT 623
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-5266
Mailing Address - Country:US
Mailing Address - Phone:210-429-2598
Mailing Address - Fax:
Practice Address - Street 1:1501 OLD MONROVIA RD NW APT 623
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-5266
Practice Address - Country:US
Practice Address - Phone:210-429-2598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician