Individual
MIA DANIELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6222 UTSA BLVD, SAN ANTONIO, TX 78249-1657
(832) 444-7653
Mailing address
6222 UTSA BLVD, SAN ANTONIO, TX 78249-1657
(832) 444-7653
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
37589410
TX
Other
Enumeration date
03/01/2019
Last updated
03/01/2019
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