Individual
PERNILLA L JOHANSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5460 BROWNINGS CORNERS RD, FLORENCE, OR 97439-8849
(541) 305-5804
Mailing address
5460 BROWNINGS CORNERS RD, FLORENCE, OR 97439-8849
(541) 305-5804
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
3060
OR
1041C0700X
Clinical Social Worker
Primary
L3060
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292270
—
OR
01
—
L3060
STATE LICENSE
OR
Enumeration date
07/10/2006
Last updated
07/24/2020
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