| NPI | 1801179098 |
|---|---|
| Former Name | TERRI RAE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: PA CW019335) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW128152) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2017-01-25 |