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1457813305
STACEY LEOTA JOHNSON
TULARE, CA
NPI
1457813305
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA C059790219)
Enumeration Date
2019-04-01
Last Update Date
2019-04-01
Business Address
STACEY LEOTA JOHNSON
559 E BARDSLEY AVE
TULARE, CA 93274-5400
Phone number: 559-688-7531
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Mailing Address
STACEY LEOTA JOHNSON
559 E BARDSLEY AVE
TULARE, CA 93274-5400
Phone number: 559-403-9687
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