| NPI | 1497095699 |
|---|---|
| Former Name | KRISTEN MICHELLE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1943) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1100) |
| 1041C0700X Social Worker, Clinical (Licence: NE 1942) | |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2024-02-15 |