Individual
LAURA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, SAC-IT
Contact information
Practice address
9532 E. 16 FRONTAGE RD, STE. 100, ONALASKA, WI 54650-6742
(608) 783-0506
(608) 783-0242
Mailing address
9532 E. 16 FRONTAGE RD, STE. 100, ONALASKA, WI 54650-6742
(608) 783-0506
(608) 783-0242
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17497-130
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003150004
—
WI
Enumeration date
02/10/2016
Last updated
03/16/2017
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