Most Relevant Information
Provider Data
| NPI Number: | 1003534413 |
| Provider Name: | LISA MARIE JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/22/2022 |
| Last Updated: | 08/22/2022 |
Provider Practice Location
91-2128 OLD FT WEAVER RD
EWA BEACH
HI
967061911
Practice Location Phone/Fax
| Phone: | 8085891829 |
| Fax: | 8085892610 |
Provider Mailing Location
91-2128 OLD FT WEAVER RD
EWA BEACH
HI
967061911
Provider Mailing Phone/Fax
| Phone: | 8085891829 |
| Fax: | 8085892610 |