Individual
MR. DESWOOD JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSW
Contact information
Practice address
BLDG # T004-006 05 MILES EAST OF 371, THOREAU, NM 87323
(505) 905-0062
(505) 905-0064
Mailing address
211 S FLORENCE ST TRLR 48, GALLUP, NM 87301-6763
(505) 905-0061
(505) 905-0064
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
860092335
NAVAJO NATION
NM
Enumeration date
10/27/2011
Last updated
10/27/2011
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