Provider Demographics
NPI:1871336784
Name:JOHNSON, PIAGET X
Entity type:Individual
Prefix:
First Name:PIAGET
Middle Name:X
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PIAGET
Other - Middle Name:X
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18363 E MAINSTREET APT 2206
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4782
Mailing Address - Country:US
Mailing Address - Phone:832-845-3612
Mailing Address - Fax:
Practice Address - Street 1:12303 E 104TH PL UNIT 105
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-2098
Practice Address - Country:US
Practice Address - Phone:720-617-1574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician