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1255716205
NISA JOHNSON
NORMAL, IL
NPI
1255716205
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149017179)
Enumeration Date
2015-07-20
Last Update Date
2022-10-24
Business Address
NISA JOHNSON
1100 BEECH ST BLDG 10-1
NORMAL, IL 61761-1568
Phone number: 309-750-0415
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Mailing Address
NISA JOHNSON
1100 BEECH ST BLDG 10-1
NORMAL, IL 61761-1568
Phone number: 309-750-0415
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