Individual
MERLE LEO JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISAC
Contact information
Practice address
12033 AGENCY RD, PARKER, AZ 85344-7718
(928) 669-3256
(928) 669-5449
Mailing address
13376 1ST AVE, PARKER, AZ 85344
(928) 669-5243
(928) 669-5449
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-0884
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
917528
AHCCCS
AZ
Enumeration date
09/27/2006
Last updated
05/03/2013
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