Individual
ASHLEY MADELINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2368 CRATER LAKE AVE, MEDFORD, OR 97504-5003
(541) 727-1592
Mailing address
2368 CRATER LAKE AVE, MEDFORD, OR 97504-5003
(541) 727-1592
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/09/2021
Last updated
02/09/2021
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