Individual
JILL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.I.
Contact information
Practice address
3609 W ROSE HILL ST, BOISE, ID 83705-1515
(208) 901-0387
Mailing address
1116 S VISTA AVE # 101, BOISE, ID 83705-2429
(208) 901-0387
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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