Individual
ANDREA NIKOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6200 SW ARCTIC DR, BEAVERTON, OR 97005-9447
(503) 224-2184
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
IN-10196787
OR
Other
Enumeration date
02/16/2019
Last updated
02/16/2019
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