Individual
EMMALEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
925 PIERCE ST APT 223, OMAHA, NE 68108-3358
(844) 743-6506
Mailing address
8300 JEFFERSON ST NE STE B, ALBUQUERQUE, NM 87113-1734
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-189719
NE
Other
Enumeration date
11/24/2021
Last updated
06/06/2022
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