Individual
CODY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
TRAILTALK, 3585 N UNIVERSITY AVE. STE 250, PROVO, UT 84604
(435) 513-2715
Mailing address
263 ASHBROOK CIRCLE, MIDVALE, UT 84047
(801) 834-1606
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9082143-3501
UT
Other
Enumeration date
10/14/2010
Last updated
04/17/2019
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