JOSH JOHANSEN

LAFAYETTE, IN
NPI1881204485
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN  87001632A)
Enumeration Date2020-08-07
Last Update Date2020-08-07
Business Address
JOSH JOHANSEN
610 MAIN ST
LAFAYETTE, IN 47901-1451
Phone number: 765-423-2638
Mailing Address
JOSH JOHANSEN
415 N 26TH ST STE 102
LAFAYETTE, IN 47904-2855
Phone number: