Individual
ANON-MALIK DEREK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
835 PROTON RD, SAN ANTONIO, TX 78258-4203
(210) 610-9175
Mailing address
835 PROTON RD, SAN ANTONIO, TX 78258-4203
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TX
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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