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Individual

CARMON JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
427 W. TRAVELERS TRAIL, BURNSVILLE, MN 55337
(612) 413-6408
Mailing address
427 W. TRAVELERS TRAIL, BURNSVILLE, MN 55337

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
MN

Other

Enumeration date
04/15/2022
Last updated
04/15/2022
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