Individual
EVAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
721 CHUCK GRAY CT, OWENSBORO, KY 42303-7308
(270) 843-5383
(615) 815-1946
Mailing address
1321 MURFREESBORO PIKE STE 410, NASHVILLE, TN 37217-2665
(615) 247-5487
(615) 815-1946
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-280656
KY
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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