Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Addiction (Substance Use Disorder) |
103TA0400X | 62 | Psychologist, Clinical | |
Social Worker |
104100000X |
| NPI Number | 1730447384 |
| LBN Legal business name | T.JOHNSON & ASSOCIATES, LLC |
| Authorized official | TRAVIS JOHNSON - (PRIVATE PRATITIONER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 05/01/2012 |
| Last updated | 05/01/2012 - About 14 years ago |
| Identifiers | n/a |
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