NPI 1194476895

Stacey Lynn Johanson

Practitioner Emotionally Disturbed Childrens' Residential Treatment Facility Ephraim, UT

Practice location

Address: 66 N 180 W, Ephraim, UT 84627-2130
Phone: (435) 283-0164

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Utah →

Registry record

NPI: 1194476895
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Jan 2022
Record last updated: 13 Jan 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.