Individual
MR. MICHAEL LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 444-5048
Mailing address
PO BOX 2927, FAYETTEVILLE, AR 72702-2927
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C - 1037
AR
Other
Enumeration date
08/11/2006
Last updated
07/08/2007
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