Individual
LAUREN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2558 KINGSTON DR, FLORENCE, SC 29505-6423
(843) 409-0914
Mailing address
2558 KINGSTON DR, FLORENCE, SC 29505-6423
(843) 409-0914
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-26922
SC
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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