Individual
GWENDOLYN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
968 ANISE LN, BOWLING GREEN, KY 42104-7775
(404) 488-7811
Mailing address
985 BRUTON CT SW, MARIETTA, GA 30064-2971
(404) 488-7811
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-70492
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/08/2022
Last updated
01/14/2024
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