Individual
WESLEY DAVID JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCDC II
Contact information
Practice address
809 SOUTH ST STE 208, RAPID CITY, SD 57701-3583
(605) 391-3482
(605) 342-8144
Mailing address
809 SOUTH ST STE 208, RAPID CITY, NJ 57701
(605) 391-3482
(605) 342-8144
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
08051365
SD
Other
Enumeration date
11/17/2011
Last updated
11/17/2011
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