Individual
KRISTINA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2805 KINGSBURRY RD, CLOVER, SC 29710-9167
(803) 504-9083
Mailing address
2805 KINGSBURRY RD, CLOVER, SC 29710-9167
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
22236257
CO
106S00000X
Behavior Technician
Primary
22236257
NC
Other
Enumeration date
02/15/2023
Last updated
03/01/2023
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