Individual
MRS. AIMEE COUGHLIN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5819 N. GREELEY AVENUE, SUITE 102, PORTLAND, OR 97217
(503) 295-7337
(509) 926-9161
Mailing address
5819 N. GREELEY AVENUE, SUITE 102, PORTLAND, OR 97217
(503) 295-7337
(509) 926-9161
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3852
OR
1041C0700X
Clinical Social Worker
3852
OR
Other
Enumeration date
06/15/2007
Last updated
10/09/2012
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