Individual
MS. ELISE LILLIAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
1798 W HUNTING PARK AVE, PHILADELPHIA, PA 19140-3408
(215) 227-4408
Mailing address
1944 S ALDEN ST, PHILADELPHIA, PA 19143-5515
(646) 546-0695
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
44SL06045100
NJ
1041S0200X
School Social Worker
Primary
SW131500
PA
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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