Individual
SHANELLE LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3423 2ND AVE STE 3, KEARNEY, NE 68847-2947
(308) 300-1983
Mailing address
3423 2ND AVE STE 3, KEARNEY, NE 68847-2947
(308) 300-1983
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
13453
NE
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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