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1104393149
DOMINIC IDRIS JOHNSON
VALLEJO, CA
NPI
1104393149
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103K00000X Behavior Analyst
Enumeration Date
2018-10-29
Last Update Date
2018-10-29
Business Address
DOMINIC IDRIS JOHNSON
150 GLEN COVE MARINA RD E STE 102
VALLEJO, CA 94591-7237
Phone number: 707-553-1784
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Mailing Address
DOMINIC IDRIS JOHNSON
2157 HILLRIDGE DR
FAIRFIELD, CA 94534-7950
Phone number: 707-344-1611
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