Provider Demographics
NPI:1154201648
Name:SINCLAIR, JOHNNA SUE
Entity type:Individual
Prefix:MRS
First Name:JOHNNA
Middle Name:SUE
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOHNNA
Other - Middle Name:
Other - Last Name:GRIMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9314 RYDER DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2000
Mailing Address - Country:US
Mailing Address - Phone:254-535-7518
Mailing Address - Fax:
Practice Address - Street 1:9314 RYDER DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-2000
Practice Address - Country:US
Practice Address - Phone:254-535-7518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician