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Individual

KASSIDI JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED, BCBA

Contact information

Practice address
3301 ROBINSON DR, WACO, TX 76706-4401
(254) 732-2262
(254) 732-2263
Mailing address
3301 ROBINSON DRIVE, WACO, TX 76707
(254) 732-2262
(254) 732-2263

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14248

Other

Enumeration date
07/06/2015
Last updated
07/06/2015
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