MATTHEW JOHANSEN

MERIDIAN, ID
NPI1487066320
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor Mental Health
(Licence: ID  LCPC-6475)
Enumeration Date2014-05-27
Last Update Date2019-02-22
Business Address
MATTHEW JOHANSEN MS, LCPC, QSUDP
2131 S BONITO WAY
MERIDIAN, ID 83642-1659
Phone number: 208-202-4729
Mailing Address
MATTHEW JOHANSEN MS, LCPC, QSUDP
6407 W ROBERTSON DR
BOISE, ID 83709-2176
Phone number: 208-836-8247
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