Individual
THERESA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BT
Contact information
Practice address
1301 MUSEUM RD, CONWAY, AR 72032-4739
(501) 358-6535
Mailing address
PO BOX 10267, CONWAY, AR 72034-0003
(501) 358-3565
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/01/2025
Last updated
05/01/2025
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