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Individual

MONIQUE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
6130 MICHIGAN RD, INDIANAPOLIS, IN 46228-1200
(773) 746-4423
Mailing address
6117 PEREGRINE BLVD, INDIANAPOLIS, IN 46228-1508
(773) 746-4423

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008592A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000
N/A
Enumeration date
06/24/2021
Last updated
06/24/2021
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