Individual
ANDREA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 PITCHKETTLE POINT CIR, SUFFOLK, VA 23434-7553
(407) 791-4317
Mailing address
105 PITCHKETTLE POINT CIR, SUFFOLK, VA 23434-7553
(407) 791-4317
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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