Individual
KURT LAURENZ JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
184 UNSER BLVD NE, RIO RANCHO, NM 87124-4045
(505) 896-0928
Mailing address
184 UNSER BLVD NE, RIO RANCHO, NM 87124-4045
(505) 818-8760
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-07771
NM
Other
Enumeration date
12/14/2011
Last updated
02/28/2012
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