| NPI | 1902458037 |
|---|---|
| Other Name | MARY ALISA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-25659) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 25659) |
| 101YM0800X Counselor, Mental Health (Licence: NC A14910) | |
| 101YP2500X Counselor, Professional (Licence: NC 14910) | |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2022-12-01 |