Individual
EDITH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
201 S LINCOLN AVE, CHANUTE, KS 66720-2463
(620) 431-6616
(620) 431-6966
Mailing address
900 E LAHARPE ST, KIRKSVILLE, MO 63501-4520
(660) 665-1962
(660) 665-3989
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1002
KS
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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