Provider Demographics
NPI:1235355546
Name:JOHNSON, TORI NIKOLE (MS)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:NIKOLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E MAIN ST # 101
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3975
Mailing Address - Country:US
Mailing Address - Phone:970-313-8628
Mailing Address - Fax:
Practice Address - Street 1:700 E MAIN ST # 101
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-3975
Practice Address - Country:US
Practice Address - Phone:970-313-8628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health