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Individual

EVAN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW

Contact information

Practice address
1429 N PROSPECT AVE, MILWAUKEE, WI 53202-3017
(414) 721-1574
Mailing address
2536 S 67TH ST, MILWAUKEE, WI 53219-2635
(414) 721-1574

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11000-123
WI

Other

Enumeration date
05/29/2023
Last updated
05/29/2023
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