Individual
GRACE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
16425 MANDERSON ST, OMAHA, NE 68116-2903
(402) 708-0237
Mailing address
16425 MANDERSON ST, OMAHA, NE 68116-2903
(402) 708-0237
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-1278
NE
101YM0800X
Mental Health Counselor
Primary
10465
NE
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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