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1245842046
TIFFANY JOHNSON
SUPERIOR, WI
NPI
1245842046
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 17142-32)
Enumeration Date
2020-08-21
Last Update Date
2024-06-14
Business Address
TIFFANY JOHNSON C-SAC
2222 E 5TH ST
SUPERIOR, WI 54880-3709
Phone number: 715-392-1955
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Mailing Address
TIFFANY JOHNSON C-SAC
2222 E 5TH ST
SUPERIOR, WI 54880-3709
Phone number: 715-392-1955
Copy
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