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Individual

KATHERINE MARIE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CADC-R

Contact information

Practice address
1 SERENITY LN, COBURG, OR 97408-9350
(541) 687-1110
Mailing address
733 E 15TH AVE APT 13, EUGENE, OR 97401-4511
(541) 780-4879

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21-CRM-568
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
09/20/2021
Last updated
11/16/2021
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