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Individual
DR. SHILENE MOULTRIE-JOHNSON
Active
Individual
DR. SHILENE MOULTRIE-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1312032
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03112367967
AMERICAN HEART ASSOCIATION/ BLS INSTRUCTOR
GA
01
—
1312032
TEACHER'S LICENSE
MA
01
—
TR-BFTS-1397
GEORGIA TRAINING APPROVAL:
GA
Enumeration date
06/10/2013
Last updated
06/10/2013
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