Individual
COREY ANTHONY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
171 LAKE ST STE 1, RAMSEY, NJ 07446-2036
(201) 620-9927
Mailing address
31 CHAMBERLAIN AVE, LITTLE FERRY, NJ 07643-1851
(201) 559-1460
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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