Individual
ANGELIS VANITY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 BRIDGEPORT AVENUE, 211, SHELTON, CT 06484
(203) 993-6592
Mailing address
50 RIDGEFIELD AVE UNIT 211, BRIDGEPORT, CT 06610-3105
(203) 892-7392
(203) 361-0134
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1262659
CT
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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