Individual
JANE LEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7 PENELOPE LN, COTUIT, MA 02635-2608
(508) 274-3233
Mailing address
7 PENELOPE LN, COTUIT, MA 02635-2608
(508) 274-3233
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10
BEHAVIORAL HEALTH
MA
Enumeration date
03/28/2016
Last updated
03/28/2016
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