Individual
CRAIG M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2565 N CURRANT PL, BOISE, ID 83704-5594
(208) 859-5373
Mailing address
2565 N CURRANT PL, BOISE, ID 83704-5594
(208) 859-5373
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
36721
ID
1041C0700X
Clinical Social Worker
Primary
42081
ID
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
06/19/2017
Last updated
03/26/2024
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