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Individual
PAMELA JOHNSON
Active
Individual
PAMELA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
570569761
TAX ID
SC
05
—
AD01AK
—
SC
Enumeration date
01/23/2013
Last updated
09/06/2018
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