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Individual

CIERA QUEEN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5540 W 111TH ST, OAK LAWN, IL 60453-5574
(708) 634-0821
Mailing address
5850 GRANITE PKWY STE 600, PLANO, TX 75024-6753

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
08/15/2024
Last updated
08/15/2024
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