Individual
MICHAEL C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9287 S AVIGNON PL, WEST JORDAN, UT 84088-9067
(801) 618-6756
Mailing address
9287 S AVIGNON PL, WEST JORDAN, UT 84088-9067
(801) 618-6756
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A10097745
—
UT
Enumeration date
11/04/2022
Last updated
12/10/2022
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