Individual
DEANNA M JOHANNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
131 N ALLUMBAUGH ST, BOISE, ID 83704-9204
(208) 367-2175
(208) 376-0285
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1093
ID
Other
Enumeration date
09/28/2009
Last updated
02/24/2016
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