Most Relevant Information
Provider Data
| NPI Number: | 1003318544 |
| Provider Name: | KODY MICHAEL JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/28/2018 |
| Last Updated: | 02/28/2018 |
Provider Practice Location
6330 NW KELLY DR STE A
PARKVILLE
MO
641524027
Practice Location Phone/Fax
| Phone: | 8164695162 |
| Fax: |
Provider Mailing Location
6330 NW KELLY DR STE A
PARKVILLE
MO
641524027
Provider Mailing Phone/Fax
| Phone: | 8164695162 |
| Fax: |