Individual
ROBBY GORDON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-2711
(208) 381-4025
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C2770
OR
101Y00000X
Counselor
Primary
LCPC 4843
ID
101Y00000X
Counselor
LH 00011315
WA
Other
Enumeration date
08/29/2013
Last updated
12/04/2023
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