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Individual

MRS. MARIANNE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1115 N MAIN ST, LOGAN, UT 84341-2217
(435) 753-7053
Mailing address
1115 N MAIN ST, LOGAN, UT 84341-2217
(435) 753-7053

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
12/10/2012
Last updated
12/10/2012
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