Individual
HALLIE M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2404 E EMPIRE ST, BLOOMINGTON, IL 61704-3630
(309) 663-8275
Mailing address
1200 SEARLE DR APT 1, NORMAL, IL 61761-2891
(130) 927-5836
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31618
—
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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