Individual
EARLENE P. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
9220 MENTOR AVENUE, BEACON HEALTH, MENTOR, OH 44060-6412
(440) 639-3509
(440) 205-1009
Mailing address
9220 MENTOR AVENUE, BEACON HEALTH, MENTOR, OH 44060-6412
(440) 639-3509
(440) 205-1009
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I.0007714-SUPV
OH
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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