Provider Demographics
NPI:1255855334
Name:JOHNSON, MARLA DEANN (BACHELORS OF ARTS)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:DEANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:BACHELORS OF ARTS
Other - Prefix:
Other - First Name:MARLA
Other - Middle Name:DEANN
Other - Last Name:ENGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BACHELORS OF ARTS
Mailing Address - Street 1:1255 PEARL ST STE 102
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3570
Mailing Address - Country:US
Mailing Address - Phone:541-151-0340
Mailing Address - Fax:
Practice Address - Street 1:1255 PEARL ST STE 102
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3570
Practice Address - Country:US
Practice Address - Phone:541-151-0340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor