Individual
LYNNETTE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5827 BLEEKER ST, STANSBURY PARK, UT 84074-3326
(801) 577-5833
Mailing address
5827 BLEEKER ST, STANSBURY PARK, UT 84074-3326
(801) 577-5833
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
48910213501
UT
Other
Enumeration date
09/21/2012
Last updated
09/21/2012
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