Individual
JASMINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14368 MANCHESTER RD STE 150, MANCHESTER, MO 63011-4093
(636) 438-0360
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
00003810
MO
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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