Individual
REID TAYLOR JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
222 TONGASS DR, SITKA, AK 99835-9416
(952) 334-7827
Mailing address
222 TONGASS DR, SITKA, AK 99835-9416
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EBT125035235001
BLUE CROSS BLUE SHIELD ALLINA HEALTH
MN
Enumeration date
10/28/2021
Last updated
06/28/2022
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