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Individual

KIAH JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4959 UTICA RIDGE RD, DAVENPORT, IA 52807-3063
(563) 362-9631
Mailing address
1805 WINDING HILL RD APT 525, DAVENPORT, IA 52807-1310

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
09/27/2022
Last updated
09/27/2022
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