Individual
TIEARRA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
444 S. 44TH ST., OMAHA, NE 68131
(402) 559-3563
Mailing address
985450 NEBRASKA MEDICAL CENTER, OMAHA, NE 68131-5450
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/12/2016
Last updated
06/29/2017
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