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Individual
SANDRA ANN JOHNSON
Active
Individual
SANDRA ANN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15920
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
774800100
—
MD
Enumeration date
07/30/2012
Last updated
11/20/2012
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