TRACE ANDREW JOHNSON

CHEYENNE, WY
NPI1538703434
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
(Licence: WY  RBT-19-103651)
Enumeration Date2019-11-04
Last Update Date2019-11-04
Business Address
TRACE ANDREW JOHNSON RBT
1704 WESTLAND RD
CHEYENNE, WY 82001-3322
Phone number: 605-271-2690
Mailing Address
TRACE ANDREW JOHNSON RBT
2804 E 26TH ST STE 1
SIOUX FALLS, SD 57103-4019
Phone number: 605-271-2690
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