Provider Demographics
NPI:1831475912
Name:JOHNSON, BRITTNEY (BCBA)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:JOHNSON
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 1:1351 GULF BLVD APT 212
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33767-2815
Mailing Address - Country:US
Mailing Address - Phone:727-316-9340
Mailing Address - Fax:
Practice Address - Street 1:1351 GULF BLVD APT 212
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33767
Practice Address - Country:US
Practice Address - Phone:727-316-9340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0114196103K00000X
FL11314887103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst