| NPI | 1942668736 |
|---|---|
| Former Name | NICHOLAS BAILEY JOHNSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2018-05-22 |