Individual
MARIO JOSEPH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
340 MAIN ST # 818, WORCESTER, MA 01608-1604
(508) 791-4976
Mailing address
324 CLARK ST, WORCESTER, MA 01606-1214
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/27/2017
Last updated
10/02/2020
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