Individual
AMANDA LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSC
Contact information
Practice address
213 FALLON AVE, WILMINGTON, DE 19804-1918
(302) 893-9470
Mailing address
213 FALLON AVE, WILMINGTON, DE 19804-1918
(302) 893-9470
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH003333
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BH003333
—
PA
Enumeration date
07/18/2022
Last updated
07/18/2022
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