Individual
KIMBERLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 PLEASANT COLONY LN, YORK, SC 29745-7745
(910) 988-0573
Mailing address
PO BOX 1011, YORK, SC 29745-1011
(910) 988-0573
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB620951
SC
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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