Individual
MR. LEROY LOUIS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
1615 OJO COURT, FARMINGTON, NM 87401
(505) 564-4804
(505) 564-4857
Mailing address
PO BOX 14, FARMINGTON, NM 87499-0014
(505) 564-4804
(505) 564-4857
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
NM
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/10/2020
Last updated
12/18/2020
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