Individual
TANYA M JOHANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1155 LISBON ST, LEWISTON, ME 04240-5025
(207) 783-9141
(207) 783-4660
Mailing address
1155 LISBON ST, LEWISTON, ME 04240-5025
(207) 783-9141
(207) 783-4660
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC5423
ME
Other
Enumeration date
04/09/2014
Last updated
05/04/2021
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