Individual
JAY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2216 BOOTHILL CT STE 3, BOZEMAN, MT 59715-7215
(406) 600-5007
Mailing address
PO BOX 978, THREE FORKS, MT 59752-0978
(406) 490-9068
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-ACLC-LIC-64298
MT
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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