Individual
DAVID CHARLES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
US HWY 64 OLD HIGH SCHOOL ROAD, SHIPROCK, NM 87420
(505) 368-5163
(505) 368-5502
Mailing address
2600 N FAIRVIEW AVE, FARMINGTON, NM 87401-4502
(505) 326-5298
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
M-3682
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34871551
—
NM
Enumeration date
03/14/2007
Last updated
07/08/2007
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