Individual
LYDIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.,L.P.C., A.T.R.
Contact information
Practice address
20700 WATERTOWN RD, SUIT 102, WAUKESHA, WI 53186-1800
(262) 782-1474
(262) 782-1441
Mailing address
2979 N 53RD ST, MILWAUKEE, WI 53210-1616
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4887-125
WI
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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