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Individual

MRS. SUZANNE ELLEN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCABA

Contact information

Practice address
2430 6TH AVE, MOLINE, IL 61265-1539
(309) 764-5555
Mailing address
1431 DODGE ST, LE CLAIRE, IA 52753-9635
(563) 271-9629

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
01/05/2015
Last updated
01/05/2015
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