Individual
TYLER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
209 CENTRE SARCELLE BLVD STE 201, YOUNGSVILLE, LA 70592-6683
(337) 857-3674
Mailing address
111 EMERY LN, CARENCRO, LA 70520-5356
(337) 258-0522
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/28/2018
Last updated
07/28/2018
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