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Individual

AMY RENEE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1969 W HART RD, BELOIT, WI 53511-2230
(608) 364-5686
(608) 363-5756
Mailing address
1969 W HART RD, BELOIT, WI 53511-2230
(608) 364-5686
(608) 363-5756

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
129186-121
WI

Other

Enumeration date
09/18/2013
Last updated
11/02/2020
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