Individual
MS. KATHLEEN MARIE JOHANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7855 S EMERSON AVE STE H, INDIANAPOLIS, IN 46237-8669
(317) 902-2205
Mailing address
5548 PAINTED MAPLE CT, INDIANAPOLIS, IN 46254-9630
(317) 902-2205
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
3304149A
IN
1041C0700X
Clinical Social Worker
Primary
34006255A
IN
Other
Enumeration date
03/02/2011
Last updated
06/08/2011
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