Individual
MICHELLE MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4353 RENDEZVOUS CIR, ANCHORAGE, AK 99504-4219
(907) 729-6319
Mailing address
4000 SAN ERNESTO AVE, ANCHORAGE, AK 99508-2874
(907) 729-5020
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5894
AK
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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