Individual
BRENDA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3720 CHUCK WAGON RD, CHEYENNE, WY 82009-9418
(307) 631-0085
Mailing address
3720 CHUCK WAGON RD, CHEYENNE, WY 82009-9418
(307) 631-0085
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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