Individual
MRS. KELLY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7324 HIGHWAY 789, LANDER, WY 82520
(307) 349-2359
(307) 332-9250
Mailing address
7324 HIGHWAY 789, LANDER, WY 82520
(307) 349-2359
(307) 332-9250
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-471
WY
Other
Enumeration date
02/20/2014
Last updated
02/20/2014
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