Individual
AUTUMN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 N AUSTIN BLVD, OAK PARK, IL 60302-5308
(708) 612-0503
Mailing address
15280 EL CAMENO TER APT 1N, ORLAND PARK, IL 60462-3693
(708) 612-0503
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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