| NPI | 1851996334 |
|---|---|
| Former Name | LAURISSA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OK 1-24-70664) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2024-06-13 |