Most Relevant Information
Provider Data
| NPI Number: | 1003688532 |
| Provider Name: | JOHANNA MEDEL VERDEJO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/27/2023 |
| Last Updated: | 10/27/2023 |
Provider Practice Location
217 STATION ST
JACKSONVILLE
NC
285466304
Practice Location Phone/Fax
| Phone: | 9103782501 |
| Fax: |
Provider Mailing Location
217 STATION ST
JACKSONVILLE
NC
285466304
Provider Mailing Phone/Fax
| Phone: | 9103782501 |
| Fax: |