Individual
CONSTANCE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
U
Credential
LCSW
Contact information
Practice address
405 W 6TH ST, BLOOMINGTON, IN 47404-3904
(812) 221-1142
Mailing address
405 W 6TH ST STE D1B, BLOOMINGTON, IN 47404-3905
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
99127183A
IN
Other
Enumeration date
11/06/2024
Last updated
11/23/2024
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