Johnson, Marla
Johnson, Marla is an individual health care provider with primary practice located at 542 4Th Ave Ste B101 , Fairbanks AK 99701-4707. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Johnson, Marla can be contacted via phone (907) 374-1097.Contact Information
Primary practice address
542 4Th Ave Ste B101
Fairbanks AK 99701-4707
Phone: (907) 374-1097
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1770175390 |
|---|---|
| LBN Legal business name | Johnson, Marla |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 4th, 2021 |
| Last updated | Feb 4th, 2021 - about 5 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 | 1770175390 | NPPES |
| Alaska | MEDICAID | 1687081 |
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