Tara Nicole Johnson

NPI #1124699954 in The Dalles, Oregon

Provider Information

NPI Number: 1124699954
Entity Type: Individual
Name: Tara Nicole Johnson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jul 2, 2021
Last Updated: Jul 2, 2021

Practice Location

Address: 401 E 3RD ST STE 101
City: The Dalles
State: Oregon
ZIP Code: 97058-2563
Phone: (541) 298-2101

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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