Johnson, Jacqueline
Johnson, Jacqueline is an individual health care provider with primary practice located at 829 Chief Eddie Hoffman Hwy , Bethel AK 99559. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Johnson, Jacqueline can be contacted via phone (907) 543-6100.Contact Information
Primary practice address
829 Chief Eddie Hoffman Hwy
Bethel AK 99559
Phone: (907) 543-6100
Fax: (907) 543-6008
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X |
Profile Details
| NPI number | 1821219130 |
|---|---|
| LBN Legal business name | Johnson, Jacqueline |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2007 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821219130 | NPPES |
| Alaska | MEDICAID | MH0150 |
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