Individual
RIESSA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1131 BROADWAY ST, BUFFALO, NY 14212-1501
(716) 896-7350
Mailing address
1131 BROADWAY ST, BUFFALO, NY 14212-1501
(716) 896-7350
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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