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1881204485
JOSH JOHANSEN
LAFAYETTE, IN
NPI
1881204485
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN 87001632A)
Enumeration Date
2020-08-07
Last Update Date
2020-08-07
Business Address
JOSH JOHANSEN
610 MAIN ST
LAFAYETTE, IN 47901-1451
Phone number: 765-423-2638
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Mailing Address
JOSH JOHANSEN
415 N 26TH ST STE 102
LAFAYETTE, IN 47904-2855
Phone number:
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