Individual
JORDAN BREANNE JOHNSON BETHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2418 E JOYCE BLVD, FAYETTEVILLE, AR 72703-4519
(479) 871-7994
Mailing address
3875 WATERHOLE AVE, SPRINGDALE, AR 72764-6733
(843) 240-1371
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-28399
AR
Other
Enumeration date
01/05/2018
Last updated
01/05/2018
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