Individual
KELLY T JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 JEWETT ST # 2, MANCHESTER, NH 03103-2823
(603) 717-4439
Mailing address
202 JEWETT ST # 2, MANCHESTER, NH 03103-2823
(603) 717-4439
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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