Individual
MRS. STEPHANIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 TEAKWOOD DR, COLUMBIA, MO 65203-5803
(208) 403-6817
Mailing address
3700 TEAKWOOD DR, COLUMBIA, MO 65203-5803
(208) 403-6817
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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