Individual
BETSY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
926 S 8TH ST, MANITOWOC, WI 54220-4535
(920) 683-4230
Mailing address
926 S 8TH ST, PO BOX 1177, MANITOWOC, WI 54220-4535
(920) 683-4230
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4218-125
WI
Other
Enumeration date
02/07/2012
Last updated
02/07/2012
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