Individual
MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1499 6TH ST, GREEN BAY, WI 54304-2252
(920) 497-6161
(888) 974-5769
Mailing address
1499 6TH ST, GREEN BAY, WI 54304-2252
(920) 497-6161
(888) 974-5769
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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