Individual
GENEVIEVE GRACE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23804 HIGHWAY 99 W, JUNCTION CITY, OR 97448-9201
(541) 225-8273
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10257833
OR
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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