Individual
HEATHER L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FSS
Contact information
Practice address
541 QUANTUM RD NE, RIO RANCHO, NM 87124-4502
(505) 994-9178
Mailing address
PO BOX 28220, SANTA FE, NM 87592-8220
(505) 471-5006
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/06/2009
Last updated
11/06/2009
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