IndividualActive
Johnny Clyde
NPI 1932864220 · Behavior Technician · Fairbanks, AK
Johnny Clyde is a Behavior Technician provider in Fairbanks, AK (NPI 1932864220).
Provider details
- NPI number
- 1932864220
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Practice location
1521 Hilton Ave
Fairbanks, AK 99701-4015
Phone: (907) 371-1308
Street-level locationGet directions
Mailing address
4020 Folker St
Anchorage, AK 99508-5321
Registry dates
- Enumerated
- 2021-11-02
- Last updated
- 2021-11-02
- Certified
- 2021-11-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.