Individual
REBECCA YVONNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
750 W USTICK RD STE 120, MERIDIAN, ID 83646-6133
(208) 366-1601
Mailing address
3008 W HIGAN ST, MERIDIAN, ID 83646-4107
(541) 619-4568
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-39790
ID
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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