Individual
JAQUISHA MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10110 19TH AVE SE APT I103, EVERETT, WA 98208-4272
(210) 557-1185
Mailing address
10110 19TH AVE SE APT I103, EVERETT, WA 98208-4272
(210) 557-1185
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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