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General NPI Number Information
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NPI Number | 1811598626
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Entity Type | Organization
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Legal Business Name | ALYSSA M. JOHNSON, INC.
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Dates
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Enumeration Date | 11/06/2020
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 709 E MAIN ST STE B
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City | BROWNSBURG
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State | IN
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Zip | 46112-1424
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Country | US
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Telephone | 317-520-1476
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Fax |
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Provider Business Mailing Address
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Address Line | 709 E MAIN ST STE B
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City | BROWNSBURG
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State | IN
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Zip | 46112-1424
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Country | US
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Telephone | 317-520-1476
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALYSSA MARIE JOHNSON
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Credential | LCSW
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Telephone | 317-520-1476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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