Individual
DEBRA LEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 S MAIN ST, SUITE 100, O FALLON, MO 63366-2807
(636) 281-1990
(636) 281-1995
Mailing address
9200 WATSON RD, SUITE G101, SAINT LOUIS, MO 63126-1528
(314) 544-3800
(314) 843-0552
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005057
MO
Other
Enumeration date
01/11/2013
Last updated
01/11/2013
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