Individual
ASHLEY RENEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2275 W BROADWAY ST STE C, IDAHO FALLS, ID 83402-2902
(208) 524-7400
(208) 524-8004
Mailing address
2275 W BROADWAY ST STE C, IDAHO FALLS, ID 83402-2902
(208) 524-7400
(208) 524-8004
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW31404
ID
Other
Enumeration date
11/08/2011
Last updated
11/08/2011
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