Most Relevant Information
Provider Data
| NPI Number: | 1003308602 |
| Provider Name: | VALERIE JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/31/2018 |
| Last Updated: | 05/31/2018 |
Provider Practice Location
705 E LAHARPE ST STE C
KIRKSVILLE
MO
635014526
Practice Location Phone/Fax
| Phone: | 6602021155 |
| Fax: |
Provider Mailing Location
1810 CRAIG RD STE 109
SAINT LOUIS
MO
631464758
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |