Individual
MRS. MIRANDA L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
9280 S MIDWAY RD, BRIMLEY, MI 49715-9223
(906) 630-0983
Mailing address
9280 S MIDWAY RD, BRIMLEY, MI 49715-9223
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-17-7940
MI
Other
Enumeration date
08/14/2017
Last updated
08/14/2017
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