Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003089798 |
---|---|
Provider Name | Ms. Heather Marie Johnson |
First Address | San Francisco, CA 94103-2603 |
Second Address | San Francisco, CA 94103-2603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2008 |
Last Update Date | 02/04/2008 |