Individual
ELANDA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
59 MAPLEDELL ST, SPRINGFIELD, MA 01109-3015
(413) 504-3093
Mailing address
59 MAPLEDELL ST, SPRINGFIELD, MA 01109-3015
(413) 504-3093
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB598720
MA
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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