Provider Demographics
NPI:1588489827
Name:JOHNSON, GIANNA ELIZABETH (BCBA)
Entity type:Individual
Prefix:MRS
First Name:GIANNA
Middle Name:ELIZABETH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:GIANNA
Other - Middle Name:ELIZABETH
Other - Last Name:BANISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:614 MAPLE LAWN DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3559
Mailing Address - Country:US
Mailing Address - Phone:571-267-9519
Mailing Address - Fax:
Practice Address - Street 1:614 MAPLE LAWN DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3559
Practice Address - Country:US
Practice Address - Phone:571-267-9519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133003996103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst