Individual provider · Type 1 NPI

Ennis Scott Samuel Johnson

Addiction (Substance Use Disorder) Counselor · San Rafael, CA

NPI number 1265138713 Active

Practice location

1601 2nd St
San Rafael, CA 94901-2712

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1265138713

Ennis Scott Samuel Johnson's National Provider Identifier is 1265138713, issued on Feb 6, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Rafael, CA. The record was last updated on Feb 6, 2023.