Individual
CARRIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 S WILLIAMS STREET, ANAMOSA, IA 52205
(319) 462-4327
Mailing address
110 S WILLIAMS ST, ANAMOSA, IA 52205
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16167
IA
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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