Provider Demographics
NPI:1316404254
Name:JOHNSON, MORIAH CARMEN
Entity Type:Individual
Prefix:
First Name:MORIAH
Middle Name:CARMEN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MORIAH
Other - Middle Name:C
Other - Last Name:CURTISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:686 RIVERVIEW DR APT 20
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1661
Mailing Address - Country:US
Mailing Address - Phone:614-787-8060
Mailing Address - Fax:
Practice Address - Street 1:686 RIVERVIEW DR APT 20
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-1661
Practice Address - Country:US
Practice Address - Phone:614-787-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health