Most Relevant Information
Provider Data
| NPI Number: | 1003454547 |
| Provider Name: | BLAIKE JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/16/2019 |
| Last Updated: | 12/16/2019 |
Provider Practice Location
152 BRAND STE 200
MURPHY
TX
750943748
Practice Location Phone/Fax
| Phone: | 4695966710 |
| Fax: |
Provider Mailing Location
16800 DALLAS PKWY STE 200
DALLAS
TX
752481961
Provider Mailing Phone/Fax
| Phone: | 4695966710 |
| Fax: |