Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003198607 |
---|---|
Provider Name | Dr. William Michael Johnson |
First Address | Kapolei, HI 96707-4223 |
Second Address | Kapolei, HI 96707-4223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2011 |
Last Update Date | 09/09/2011 |