Individual
JONATHAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
24 AIRPORT RD, WEST LEBANON, NH 03784-1663
(603) 298-6617
Mailing address
144 WATERSTON AVE, QUINCY, MA 02170-3432
(617) 842-1205
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/14/2012
Last updated
03/03/2020
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