Individual
KRISTEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 FRIEDMAN AVE, LAS VEGAS, NM 87701-4231
(505) 454-5137
Mailing address
700 FRIEDMAN AVE, LAS VEGAS, NM 87701-4231
(505) 454-5137
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-08234
NM
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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