Stacey Lynn Johanson
Stacey Lynn Johanson is an Emotionally Disturbed Childrens' Residential Treatment Facility in Ephraim, Utah. Practices as a sole proprietor. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
66 N 180 WEphraim, UT 84627-2130
Phone: (435) 283-0164
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Specialties & licences
| Emotionally Disturbed Childrens' Residential Treatment Facility (primary) | Taxonomy 322D00000X |
|---|
Record details
| NPI number | 1194476895 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | January 13, 2022 |
| Last updated in NPPES | January 13, 2022 |
| Certification date | January 13, 2022 |
| Mailing address | 66 N 180 W, Ephraim, UT 84627-2130 |
Other providers in Ephraim
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Darcey Bardsley
66 N 180 W, Ephraim, UT 84627-1111 · (435) 283-0164
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Ranae Reynolds Newland
66 N 180 W, Ephraim, UT 84627-2130 · (435) 283-0164