Johnson, Theresa B
Johnson, Theresa B is an sole proprietor health care provider with primary practice located at 6827 S Brook Forest Rd , Evergreen CO 80439-7020. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Johnson, Theresa B can be contacted via phone (404) 643-3621.Contact Information
Primary practice address
6827 S Brook Forest Rd
Evergreen CO 80439-7020
Phone: (404) 643-3621
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X |
Profile Details
| NPI number | 1649609082 |
|---|---|
| LBN Legal business name | Johnson, Theresa B |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 6th, 2013 |
| Last updated | Apr 1st, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649609082 | NPPES |
| Colorado | MEDICAID | 9000141643 |
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