Individual
AMBREANA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3130 JACKSON AVE, TYLER, TX 75705-3306
(931) 494-3265
Mailing address
3130 JACKSON AVE, TYLER, TX 75705-3306
(931) 494-3265
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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