Most Relevant Information
Provider Data
| NPI Number: | 1003555756 |
| Provider Name: | KEYANNA JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | 21165699 |
Most Important Dates
| Enumeration Date: | 06/01/2022 |
| Last Updated: | 06/02/2022 |
Provider Practice Location
537 DELTONA BLVD STE 101
DELTONA
FL
327258017
Practice Location Phone/Fax
| Phone: | 9148788683 |
| Fax: |
Provider Mailing Location
874 ORIENTA AVE APT A
ALTAMONTE SPRINGS
FL
327015656
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |