Individual
JORDAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 BI COUNTY BLVD, FARMINGDALE, NY 11735-3988
(516) 828-2602
Mailing address
500 BI COUNTY BLVD, FARMINGDALE, NY 11735-3988
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/19/2021
Last updated
09/19/2021
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