Individual
DAVID R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0522
Mailing address
4430 MISSOURI AVE # 1267, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0522
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.008090
IL
1041C0700X
Clinical Social Worker
Primary
149.014797
IL
Other
Enumeration date
06/03/2012
Last updated
07/09/2021
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