Johnny Richard Clyde

NPI #1932864220 in Fairbanks, Alaska

Provider Information

NPI Number: 1932864220
Entity Type: Individual
Name: Johnny Richard Clyde
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Nov 2, 2021
Last Updated: Nov 2, 2021

Practice Location

Address: 1521 HILTON AVE
City: Fairbanks
State: Alaska
ZIP Code: 99701-4015
Phone: (907) 371-1308

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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