| NPI | 1780600858 |
|---|---|
| Former Name | SHAUNA M. JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3097-57) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 7400-123) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2022-04-21 |