Provider Demographics
NPI:1376063768
Name:JOHNSON HOWE, INDIRA SHARLEEN (CHAPLAIN)
Entity Type:Individual
Prefix:
First Name:INDIRA
Middle Name:SHARLEEN
Last Name:JOHNSON HOWE
Suffix:
Gender:F
Credentials:CHAPLAIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 MEADOWBROOK DR APT 532
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6856
Mailing Address - Country:US
Mailing Address - Phone:850-591-5320
Mailing Address - Fax:
Practice Address - Street 1:532 MEADOWBROOK DR APT 532
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6856
Practice Address - Country:US
Practice Address - Phone:850-591-5320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist