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NPI Profile for KELLEY L JOHNSON in GREAT BEND, KS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI Number | 1639296759 |
|
| Status | Active | |
| Credentials | LCPC-S, LCAC | |
| Entity | Individual | |
| Enumeration date | 03/23/2007 | |
| Last updated | 04/02/2025 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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KELLEY L JOHNSON
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