Individual
LISA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2929 S ADAMS DR, MADRAS, OR 97741-9288
(541) 325-3296
Mailing address
2929 S ADAMS DR, MADRAS, OR 97741-9288
(541) 325-3296
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/15/2021
Last updated
12/15/2021
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