Individual
TIMOTHY EDWARD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1075 N MAIN STREET, CHELSEA, MI 48118
(248) 372-9825
Mailing address
1075 N MAIN STREET, CHELSEA, MI 48118
(248) 372-9825
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
J525793189116
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
02/06/2019
Last updated
06/11/2019
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