Individual
SHAUNA O'PHARROW-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
4272 SOUTH TIMBERLAND LOOP, WASILLA, AK 99654
(907) 841-6377
Mailing address
501 LILY DR APT 2, FORT WAINWRIGHT, AK 99703-1503
(252) 876-7526
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-75068
AK
Other
Enumeration date
01/07/2019
Last updated
01/07/2019
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