Individual
MOLLY ELIZABETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2945 MCMILLAN AVE, SAN LUIS OBISPO, CA 93401-6766
(805) 439-4839
Mailing address
2945 MCMILLAN AVE, SAN LUIS OBISPO, CA 93401-6766
(805) 439-4839
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
35546
CA
Other
Enumeration date
05/17/2019
Last updated
05/17/2019
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