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1164074969
JOHN DURELL JOHNSON
GULFPORT, MS
NPI
1164074969
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: MS RBT-18-51783)
Enumeration Date
2019-07-11
Last Update Date
2019-07-11
Business Address
JOHN DURELL JOHNSON RBT
9480 THREE RIVERS RD
GULFPORT, MS 39503-4248
Phone number: 228-313-3106
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Mailing Address
JOHN DURELL JOHNSON RBT
102 KELLEY CV
PASS CHRISTIAN, MS 39571-2226
Phone number: 504-756-9044
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