Individual
ELIZABETH HANNAH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1276 W RIVER ST, BOISE, ID 83702-7066
(208) 338-4699
Mailing address
1276 W RIVER ST, BOISE, ID 83702-7066
(208) 338-4699
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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