| NPI | 1871102996 |
|---|---|
| Former Name | JESSICA NICOLE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-21-48575) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: 0-20-11223) |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2022-01-03 |