Individual
MARIAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
755 BAYWOOD DR FL 2, PETALUMA, CA 94954-5510
(707) 888-4157
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
08/02/2024
Last updated
06/23/2025
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