Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 1528 | MT |
N | 101YM0800X | Mental Health Counselor | ||
N | 103K00000X | Behavior Analyst |
NPI | 1003111451 |
---|---|
Provider Name | Ms. Linda Faye Johnson |
First Address | Missoula, MT 59804-2933 |
Second Address | Missoula, MT 59804-2933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2011 |
Last Update Date | 17/01/2011 |