| Doctor Name: | KELSEY JOY-MARIE JOHNSON |
| NPI Number: | 1609251115 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | E2722-S |
| Business Practice Address: | 625 N Sandusky Ave Upper Sandusky, OH - 433511037 |
| Business Phone Number: | 4192945795 |
| Business Fax Number: | |
| Mailing Address: | Po Box 103, PEMBERVILLE |
| State: | OH |
| Postal Code: | 434500103 |
| Phone Number: | 4196515909 |
| Fax Number: | |
| NPI Enumeration Date: | 07/26/2015 |
| NPI Last Update Date: | 07/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | E2722-S |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |