Individual
ANJULI SHAH-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5014 NE 15TH AVE, PORTLAND, OR 97211-4406
(773) 991-0103
Mailing address
5014 NE 15TH AVE, PORTLAND, OR 97211-4406
(773) 991-0103
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149012025
IL
Other
Enumeration date
06/15/2009
Last updated
01/17/2024
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