Individual
JENNIFER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
211 S POPLAR AVE, PIERRE, SD 57501-1845
(605) 280-2194
Mailing address
211 S POPLAR AVE, PIERRE, SD 57501-1845
(605) 280-2194
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548336860
—
SD
Enumeration date
07/14/2016
Last updated
07/14/2016
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