Provider Information for 1164801858
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SHILA SUEANN JOHNSON LAC, LCPC
Sex: Female
NPI: 1164801858
Last Updated: 2015-08-31
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1164801858 | ||||||||||||
| Enumeration Date | 2015-05-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 51023 BILLINGS, MT 59105-1023 United States Phone: 406-839-3804 | Fax: | ||||||||||||
| Primary Practice Address | 1643 24TH ST W SUITE 309 BILLINGS, MT 59102-2677 United States Phone: 406-839-3804 | Fax: | ||||||||||||
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