| NPI | 1457457889 |
|---|---|
| Former Name | MARILEE KAY JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD 2111) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 06051267) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2022-12-27 |