Individual
HOLLY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3113 1ST AVE SW, CEDAR RAPIDS, IA 52405-4524
(319) 560-0230
(319) 298-0970
Mailing address
3113 1ST AVE SW, CEDAR RAPIDS, IA 52405-4524
(319) 560-0230
(319) 298-0970
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101342
—
IA
Enumeration date
12/08/2014
Last updated
12/08/2014
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