Jerry Randall Johnson, BSW

NPI #1679858344 in West Frankfort, Illinois

Provider Information

NPI Number: 1679858344
Entity Type: Individual
Name: Jerry Randall Johnson, BSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: BSW
Enumeration Date: Oct 13, 2011
Last Updated: Oct 13, 2011

Practice Location

Address: 902 W MAIN ST
City: West Frankfort
State: Illinois
ZIP Code: 62896-2210
Phone: (618) 937-6483

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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