Individual
MARK D JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
320 W 8TH ST, SUITE 110, BLOOMINGTON, IN 47404-3748
(812) 333-9800
Mailing address
3473 E BETHEL LN, BLOOMINGTON, IN 47408-9386
(812) 272-4846
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/20/2006
Last updated
10/02/2012
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