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Individual

EMMY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5537 N CLARK ST, UNIT B-1, CHICAGO, IL 60640-1222
(773) 368-9619
Mailing address
5537 N CLARK ST, UNIT B-1, CHICAGO, IL 60640-1222

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
32137
IL
1041C0700X
Clinical Social Worker
Primary
149.017877
IL

Other

Enumeration date
01/01/2015
Last updated
12/07/2015
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