Individual
RODERICK VERNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
860 E 4500 S, SUITE 302, SALT LAKE CITY, UT 84107-3002
(801) 685-9600
(801) 268-3777
Mailing address
860 E 4500 S, SUITE 302, SALT LAKE CITY, UT 84107-3002
(801) 685-9600
(801) 268-3777
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
134722-3501
UT
1041C0700X
Clinical Social Worker
Primary
134722-3501
UT
Other
Enumeration date
10/11/2005
Last updated
11/05/2012
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