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Individual

KELLY BROOKE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
344 E 100 S STE 301, SALT LAKE CITY, UT 84111-1727
(801) 322-4257
Mailing address
115 S 1100 E UNIT 301, SALT LAKE CITY, UT 84102-1528

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
06/08/2010
Last updated
06/08/2010
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