Individual
RENEE JOHANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
750 W USTICK RD STE 120, MERIDIAN, ID 83646-6133
(986) 200-7921
Mailing address
23966 BLESSINGER RD, STAR, ID 83669-5016
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8331145
ID
Other
Enumeration date
06/14/2021
Last updated
07/15/2025
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