Individual
JEDIDIAH J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
702 HICKORY ST, ARKADELPHIA, AR 71923-5040
(870) 464-1337
Mailing address
702 HICKORY ST, ARKADELPHIA, AR 71923-5040
(870) 464-1337
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
AR
Other
Enumeration date
04/30/2020
Last updated
12/21/2021
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