Individual
AVERY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6420 S 193RD AVE, OMAHA, NE 68135-3947
(402) 397-9688
Mailing address
6420 S 193RD AVE, OMAHA, NE 68135-3947
(402) 397-9866
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/20/2023
Last updated
12/13/2024
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