| NPI | 1568493336 |
|---|---|
| Former Name | ANDREA NELCH JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180006194) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: IL AJ036901003P) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-07-08 |