Individual
PAULINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
417 LANARK RD, SAINT LOUIS, MO 63137-4013
(661) 557-2458
Mailing address
PO BOX 21342, SAINT LOUIS, MO 63115-0442
(661) 557-2458
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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