Individual
TIMOTHY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4080 PARADISE RD # 15-297, LAS VEGAS, NV 89169-4834
(702) 883-9591
Mailing address
4080 PARADISE RD # 15-297, LAS VEGAS, NV 89169-4834
(702) 883-9591
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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