Provider Demographics
NPI:1215295415
Name:JOHNSON, BRITTANY KRISTINE (BCABA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:KRISTINE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 S FEDERAL HWY STE C8
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-3267
Mailing Address - Country:US
Mailing Address - Phone:954-257-0696
Mailing Address - Fax:954-206-0827
Practice Address - Street 1:2905 S FEDERAL HWY STE C8
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-3267
Practice Address - Country:US
Practice Address - Phone:954-257-0696
Practice Address - Fax:954-206-0827
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-12-4442103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst