Individual
KELLY LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
559 ZOR SHRINE PL, MADISON, WI 53719-2068
(608) 833-0123
Mailing address
9327 N EVANSVILLE BROOKLYN RD, EVANSVILLE, WI 53536-9241
(608) 699-2699
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/19/2018
Last updated
06/19/2018
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