| NPI | 1639554199 |
|---|---|
| Former Name | MICHELLE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 9457168-3502) |
| Additional Taxonomies | 104100000X Social Worker (Licence: UT 9457168-3502) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2022-06-09 |