| NPI | 1003548629 |
|---|---|
| Former Name | MEGAN LEA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC014377) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701011152) |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2025-08-04 |