Individual
JESSICA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 S KEYSTONE CIR, MUNCIE, IN 47303-4477
(765) 215-9065
Mailing address
112 S KEYSTONE CIR, MUNCIE, IN 47303-4477
(765) 215-9065
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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