Individual
MADISON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7313 EAGLE CREST BLVD, EVANSVILLE, IN 47715-8157
(812) 902-1173
(765) 448-1864
Mailing address
2785 CASON ST # 2, LAFAYETTE, IN 47904-2843
(765) 446-4185
(765) 448-1864
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-66234
IN
Other
Enumeration date
06/13/2023
Last updated
06/13/2023
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