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Individual

MR. AL-NASIR MUHAMMAD ALI JOHNSON I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
88 CESAR CHAVEZ ST APT 233, SAINT PAUL, MN 55107-2397
(612) 407-0047
Mailing address
88 CESAR CHAVEZ ST APT 233, SAINT PAUL, MN 55107-2397
(612) 477-6007

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
W383209086014
MN
106E00000X
Assistant Behavior Analyst
W383209086014
MN
106S00000X
Behavior Technician
Primary
W383209086014
MN

Other

Enumeration date
10/01/2024
Last updated
10/01/2024
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