Dylan Wade Johnson

NPI #1033800693 in Kennett, Missouri

Provider Information

NPI Number: 1033800693
Entity Type: Individual
Name: Dylan Wade Johnson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 16, 2023
Last Updated: May 16, 2023

Practice Location

Address: 925 STATE ROUTE VV
City: Kennett
State: Missouri
ZIP Code: 63857-3822
Phone: (573) 888-5925

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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