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Individual

ADEFISAYO JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
307 N CHAPEL GATE LN APT E, BALTIMORE, MD 21229-2457
(410) 736-0149
Mailing address
307 N CHAPEL GATE LN APT E, BALTIMORE, MD 21229-2457
(410) 736-0149

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
0000

Other

Enumeration date
01/16/2017
Last updated
01/16/2017
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