Individual
GENEVIEVE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1315 FORTINO BLVD, PUEBLO, CO 81008-1981
(719) 545-2746
Mailing address
1315 FORTINO BLVD, PUEBLO, CO 81008-1981
(719) 545-2746
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/05/2014
Last updated
08/04/2015
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