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Individual

ANGELIQUE STEPHANIE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1419 AUWAIKU ST, KAILUA, HI 96734-3702
(808) 694-9573
Mailing address
1419 AUWAIKU ST, KAILUA, HI 96734-3702

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
03/14/2019
Last updated
03/14/2019
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