Individual
MARY ELIZABETH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1329 AMMON PARK DR, AMMON, ID 83406-4591
(208) 403-0135
Mailing address
30131 BULVERDE LN UNIT 371, BULVERDE, TX 78163-8821
(602) 300-7302
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
65860
TX
104100000X
Social Worker
Primary
8911068
ID
Other
Enumeration date
06/06/2022
Last updated
01/21/2025
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