Individual
MARY A. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LPC
Contact information
Practice address
202 SE DORION AVE, SUITE 103, PENDLETON, OR 97801-2576
(541) 276-2471
Mailing address
202 SE DORION AVE, SUITE 103, PENDLETON, OR 97801-2576
(541) 276-2471
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
92271
NM
101YP2500X
Professional Counselor
Primary
C2898
OR
Other
Enumeration date
05/25/2012
Last updated
05/25/2012
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