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1962110916
EZRA JOHNSON
COLUMBIA, SC
NPI
1962110916
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: SC RBT-21-192786)
Enumeration Date
2022-11-08
Last Update Date
2022-11-08
Business Address
EZRA JOHNSON RBT
3401 COLONIAL DR
COLUMBIA, SC 29203-6934
Phone number: 803-394-5619
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Mailing Address
EZRA JOHNSON RBT
3401 COLONIAL DR
COLUMBIA, SC 29203-6934
Phone number: 803-394-5619
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