Individual
TIMOTHY LEE JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
499 MANOR DR, EBENSBURG, PA 15931-4917
(814) 471-1801
(814) 472-4699
Mailing address
499 MANOR DR, EBENSBURG, PA 15931-4917
(814) 471-1801
(814) 472-4699
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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