Jessica Fae Johansen

NPI #1780238519 in Slc, Utah

Provider Information

NPI Number: 1780238519
Entity Type: Individual
Name: Jessica Fae Johansen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Jul 30, 2019
Last Updated: Jul 30, 2019

Practice Location

Address: 344 E 100 S
City: Slc
State: Utah
ZIP Code: 84111-1700
Phone: (801) 322-3397

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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