| NPI | 1336763960 |
|---|---|
| Former Name | MERCEDES NICOLE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.177104) |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2025-07-21 |