Individual
COURTNEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 13TH ST, COLUMBUS, GA 31901-2246
(706) 780-1704
Mailing address
1134 VALLEY ROAD, LUMPKIN, GA 31815-6031
(229) 886-7830
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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