| NPI | 1265807069 |
|---|---|
| Former Name | GRESSA JOHANSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2022-06-21 |