Individual
MARJORIE MAE JOHNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2451 E BASELINE RD STE 420, GILBERT, AZ 85234-2472
(480) 474-4173
(480) 422-2436
Mailing address
9424 E KIVA AVE, MESA, AZ 85209-1158
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-132144
AZ
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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