Individual
ASHLEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 BUFFALO RD STE 1, LEWISBURG, PA 17837-1206
(570) 523-6787
Mailing address
276 GRAYLYN CREST DR, NEW COLUMBIA, PA 17856-9418
(570) 523-6787
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272112814
—
PA
Enumeration date
09/19/2019
Last updated
09/19/2019
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