| NPI | 1922424407 |
|---|---|
| Professional Name | ALLEN JEROME JOHNSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 301018) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 99111062) |
| Enumeration Date | 2014-03-09 |
| Last Update Date | 2014-03-09 |