Individual
CHARLES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
740 E 3900 S, # 100, SALT LAKE CITY, UT 84107-2181
(801) 313-0555
Mailing address
3517 W 1500 N, WEST POINT, UT 84015-8354
(801) 336-6946
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5011958-3502
UT
Other
Enumeration date
05/26/2011
Last updated
05/26/2011
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