Individual
MRS. JESSICA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED; BCBA
Contact information
Practice address
7175 COLUMBIA GATEWAY DR, COLUMBIA, MD 21046-2534
(888) 344-5977
Mailing address
20301 THUNDERHEAD WAY, GERMANTOWN, MD 20874-3806
(724) 510-1813
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-23699
MD
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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