| NPI | 1770745457 |
|---|---|
| Professional Name | JACK EUGENE JOHNSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 00-11-45) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 17-CRM-078) |
| 101YM0800X Counselor, Mental Health (Licence: OR 24-QMHPC-001514) | |
| 1041C0700X Social Worker, Clinical (Licence: OR A11750) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2025-01-30 |