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Individual

MACY NECOLE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1033 LARCHWOOD RD, MANSFIELD, OH 44907-2424
(419) 747-4122
(419) 747-4126
Mailing address
407 W CHURCH ST, GALION, OH 44833-1602
(740) 360-7789

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
12/29/2017
Last updated
12/29/2017
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