Individual
MRS. MARY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. BCBA
Contact information
Practice address
18044 AUTUMN LEAVES DR, PRAIRIEVILLE, LA 70769-5206
(225) 270-2974
(225) 621-2534
Mailing address
18044 AUTUMN LEAVES DR, PRAIRIEVILLE, LA 70769-5206
(225) 270-2974
(225) 621-2534
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/16/2013
Last updated
12/16/2013
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