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Individual

TABBATHA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4201 N 1-10 SERVICE RD W., METARIE, LA 70006
(999) 999-9999
Mailing address
500 FAIRWAY DR STE 102, DEERFIELD BEACH, FL 33441-1817

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
LA

Other

Enumeration date
10/19/2021
Last updated
10/19/2021
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