| NPI | 1790091171 |
|---|---|
| Former Name | KRISTEN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 4161) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 05942) |
| 1041C0700X Social Worker, Clinical (Licence: MO 2010028026) | |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2023-06-27 |