Most Relevant Information
Provider Data
| NPI Number: | 1003461054 |
| Provider Name: | LEA S JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/07/2019 |
| Last Updated: | 08/07/2019 |
Provider Practice Location
1513 LIATRIS LN
NORTH POLE
AK
997055082
Practice Location Phone/Fax
| Phone: | 8654051748 |
| Fax: |
Provider Mailing Location
1513 LIATRIS LN
NORTH POLE
AK
997055082
Provider Mailing Phone/Fax
| Phone: | 8654051748 |
| Fax: |