Individual
JORDAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1834 FIELDS BLVD, GREENFIELD, IN 46140-3029
(814) 602-3287
Mailing address
1834 FIELDS BLVD, GREENFIELD, IN 46140-3029
(317) 527-5437
(317) 318-1356
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-25355
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300011398
—
IN
Enumeration date
08/03/2016
Last updated
11/05/2019
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