Individual
MRS. ELLEN STORM JOHANNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
6121 INDIAN SCHOOL RD NE STE 141, ALBUQUERQUE, NM 87110-3176
(505) 888-1362
Mailing address
6121 INDIAN SCHOOL RD NE STE 141, ALBUQUERQUE, NM 87110-3176
(505) 888-1362
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
0192981
NM
Other
Enumeration date
11/20/2017
Last updated
11/20/2017
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