Individual
VICTORIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SOLE PROPRIETOR
Contact information
Practice address
2920 N 24TH AVE STE 270, PHOENIX, AZ 85015-5961
(602) 679-3465
Mailing address
7406 S 29TH LN, PHOENIX, AZ 85041-9302
(480) 823-2751
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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