NPI 1003613118

Candace Johnson

Practitioner Behavior Technician Fort Wayne, IN

Practice location

Address: 4410 Executive Blvd, Fort Wayne, IN 46808-1135
Phone: (888) 515-1793
Mailing address: 8413 Spyglass Dr, Indianapolis, IN 46260-1937

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

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Registry record

NPI: 1003613118
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Feb 2025
Record last updated: 26 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.