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Individual

MRS. TRACI JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5607 W 75TH TER, PRAIRIE VILLAGE, KS 66208-4517
(913) 957-0623
Mailing address
5607 W 75TH TER, PRAIRIE VILLAGE, KS 66208-4517
(913) 957-0623

Taxonomy

Speciality
Code
Description
License number
State
101YS0200X
School Counselor
9167156576
KS
104100000X
Social Worker
Primary
7918
KS

Other

Enumeration date
01/09/2020
Last updated
10/16/2023
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