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Individual

DELAINE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
132 PERRY ST, TRENTON, NJ 08618-3968
(609) 394-8988
Mailing address
132 PERRY ST, TRENTON, NJ 08618-3968
(609) 394-8988

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1770796575
NJ
05
1922353572
NJ
Enumeration date
12/19/2013
Last updated
12/19/2013
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