Individual
LUCILLE D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1500 KANAKANAK ROAD, DILLINGHAM, AK 99576-0310
(907) 842-4139
(907) 842-4106
Mailing address
1500 KANAKANAK ROAD, DILLINGHAM, AK 99576-0310
(907) 842-4139
(907) 842-4106
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM9470
—
AK
Enumeration date
08/19/2011
Last updated
08/19/2011
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