Provider Demographics
NPI:1760044077
Name:JOHNSON-TOW, BARBARA (BSW CDC I)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:JOHNSON-TOW
Suffix:
Gender:F
Credentials:BSW CDC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1786 E NEIL CIR APT 1
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8240
Mailing Address - Country:US
Mailing Address - Phone:907-414-0191
Mailing Address - Fax:
Practice Address - Street 1:2521 E MOUNTAIN VILLAGE DR STE F
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7373
Practice Address - Country:US
Practice Address - Phone:907-290-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4398101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)