| NPI | 1700116993 |
|---|---|
| Former Name | ROSEANNE LEE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 083560-1) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2016-10-17 |