Most Relevant Information
Provider Data
| NPI Number: | 1003397001 |
| Provider Name: | SALLY E. JOHNSON LICSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 104390 |
Most Important Dates
| Enumeration Date: | 08/27/2018 |
| Last Updated: | 08/27/2018 |
Provider Practice Location
199 BEACON ST
MILTON
MA
021861034
Practice Location Phone/Fax
| Phone: | 6173209177 |
| Fax: |
Provider Mailing Location
199 BEACON ST
MILTON
MA
021861034
Provider Mailing Phone/Fax
| Phone: | 6173209177 |
| Fax: |