Individual
MANDY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
25604 STATE HIGHWAY 112, CAMERON, OK 74932-2612
(479) 252-0707
Mailing address
808 SKYVIEW DR, GREENWOOD, AR 72936-8274
(479) 252-0707
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
RBT-22-198452
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-24-74133
BCBA LICENSE NUMBER
OK
05
—
294775706
—
AR
Enumeration date
02/21/2022
Last updated
07/23/2025
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