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Individual
MATTHEW EVAN JOHNSON
Active
Individual
MATTHEW EVAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00775
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDP00775
LCDP
RI
Enumeration date
03/11/2019
Last updated
03/20/2019
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