Individual
MS. DIANA ELLEN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2 RACHEL LN, IVORYTON, CT 06442-1154
(860) 304-0469
Mailing address
2 RACHEL LN, IVORYTON, CT 06442-1154
(860) 304-0469
Taxonomy
Speciality
Code
Description
License number
State
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
002865
CT
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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