Individual
MR. TRAVIS IAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5594 AISEK ST., JUNEAU, AK 99801
(907) 780-3048
(907) 780-3053
Mailing address
5597 AISEK ST, JUNEAU, AK 99801-9522
(907) 500-3044
(907) 780-4098
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/27/2021
Last updated
08/27/2021
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