| NPI | 1336387539 |
|---|---|
| Former Name | PATRICIA ANN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302400) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2009-01-26 |