| NPI | 1083177604 |
|---|---|
| Former Name | ANNIKA MICHELE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 3425) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA MC60969986) |
| 101YM0800X Counselor, Mental Health (Licence: WA MC60969986) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2022-05-09 |