Individual
TIFFANIE ELLIS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA, LBA
Contact information
Practice address
1905 HUGUENOT RD STE 305, NORTH CHESTERFIELD, VA 23235-4312
(804) 690-1980
Mailing address
1905 HUGUENOT RD STE 305, NORTH CHESTERFIELD, VA 23235-4312
(804) 690-1980
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000178
VA
Other
Enumeration date
02/20/2015
Last updated
02/20/2015
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