Individual
CARISSA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10370 BATTLEVIEW PKWY, MANASSAS, VA 20109-2338
(571) 364-0440
Mailing address
10370 BATTLEVIEW PKWY, MANASSAS, VA 20109-2338
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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