Most Relevant Information
Provider Data
| NPI Number: | 1003508854 |
| Provider Name: | VERSHONNE JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/22/2023 |
| Last Updated: | 05/22/2023 |
Provider Practice Location
6909 OLD HIGHWAY 441 S STE 119
MOUNT DORA
FL
327577039
Practice Location Phone/Fax
| Phone: | 3523585001 |
| Fax: | 3175208200 |
Provider Mailing Location
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS
IN
462686135
Provider Mailing Phone/Fax
| Phone: | 4632234591 |
| Fax: | 3175208200 |