Individual
JAACQUELYN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA SOCIOLOGY
Contact information
Practice address
2207 IOELA ST, KILAUEA, HI 96754-5321
(907) 360-6614
Mailing address
2207 IOELA ST, KILAUEA, HI 96754-5321
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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