Provider Demographics
NPI:1245472299
Name:JOHNSON, JENNIFER NICOLE FINNEY (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NICOLE FINNEY
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18521 E QUEEN CREEK RD
Mailing Address - Street 2:SUITE 105-627
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-5866
Mailing Address - Country:US
Mailing Address - Phone:520-954-4249
Mailing Address - Fax:
Practice Address - Street 1:18521 E QUEEN CREEK RD
Practice Address - Street 2:SUITE 105-627
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-5866
Practice Address - Country:US
Practice Address - Phone:520-954-4249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst