Individual
CHERYL LEE ANN JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
630 HAINES AVE NW, ALBUQUERQUE, NM 87102-1226
(505) 268-5611
(505) 268-5736
Mailing address
3212 RONDA DE LECHUSAS NW, ALBUQUERQUE, NM 87120-1505
(559) 270-0750
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/26/2019
Last updated
11/03/2022
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