Individual
MICHAEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2656 W STATE ST, SUITE 517, OLEAN, NY 14760-1871
(716) 244-8083
Mailing address
2656 W STATE ST, OLEAN, NY 14760-1871
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
18165
NY
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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