Individual
JENNIFER RENEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FDN
Contact information
Practice address
4221 W FARM VIEW DR, BOISE, ID 83714-9354
(702) 557-4451
Mailing address
4221 W FARM VIEW DR, BOISE, ID 83714-9354
(702) 557-4451
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
NA
ID
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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