Individual
ELIZABETH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3165 MCKELVEY RD STE 200, BRIDGETON, MO 63044-2550
(314) 206-3900
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
00004535
IL
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
01/12/2018
Last updated
01/29/2019
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