Individual
VANESSA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1276 W RIVER ST, BOISE, ID 83702-7066
(208) 338-4699
Mailing address
9834 W MARTINGALE DR, BOISE, ID 83709-1410
(208) 599-3596
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
LCSW-41068
ID
Other
Enumeration date
05/04/2016
Last updated
11/16/2023
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