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Individual

MISS KELLY M JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10 PARSONAGE RD STE 318, EDISON, NJ 08837-2429
(888) 261-1110
(866) 696-7991
Mailing address
83 E WALNUT ST, METUCHEN, NJ 08840-2705

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
06/05/2017
Last updated
06/05/2017
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