MS. Laurel Michelle Johnson, RBT-17-43570

NPI #1598254260 in Dixon, Illinois

Provider Information

NPI Number: 1598254260
Entity Type: Individual
Name: MS. Laurel Michelle Johnson, RBT-17-43570
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Credential: RBT-17-43570
Enumeration Date: May 8, 2018
Last Updated: May 8, 2018

Practice Location

Address: 2006 GRAND DETOUR RD
City: Dixon
State: Illinois
ZIP Code: 61021-9537
Phone: (815) 540-6704

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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