Individual
MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5501 DELMAR BLVD STE B300, SAINT LOUIS, MO 63112-3078
(314) 897-0759
Mailing address
1325 BOBOLINK DR, FLORISSANT, MO 63031-3603
(636) 725-9306
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/25/2023
Last updated
04/25/2023
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