Individual
BENTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1301B HARRISON AVE, MCCOMB, MS 39648-2829
(601) 600-2429
(601) 600-2428
Mailing address
1301B HARRISON AVE, MCCOMB, MS 39648-2829
(601) 600-2429
(601) 600-2428
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C4173
MS
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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