Individual
ANJANIQUE KYNDRA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1133 COLOMA WAY, ROSEVILLE, CA 95661-4412
(916) 774-6647
Mailing address
4301 PIRAIEUS CT, ELK GROVE, CA 95758-6090
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/05/2017
Last updated
01/17/2018
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