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Individual

GRACE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12760 W 87TH STREET PKWY, LENEXA, KS 66215-4635
(816) 668-8977
Mailing address
19217 36TH AVE W STE 210, LYNNWOOD, WA 98036-5751
(657) 444-9002

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
12/19/2017
Last updated
08/13/2019
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