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1992296776
JALESA AMANDA JOHNSON
BERLIN, MD
NPI
1992296776
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: DE 1796719)
Enumeration Date
2018-05-28
Last Update Date
2018-05-28
Business Address
JALESA AMANDA JOHNSON
10514 RACETRACK RD STE G
BERLIN, MD 21811-3241
Phone number: 410-973-2301
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Mailing Address
JALESA AMANDA JOHNSON
10514 RACETRACK RD STE G
BERLIN, MD 21811-3241
Phone number: 410-973-2301
Copy
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