Individual
MISS KEYONDA SHAYLA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC RESIDENT
Contact information
Practice address
3800 BELSPRING RD, CHESTER, VA 23831-4612
(804) 252-0126
Mailing address
3800 BELSPRING RD, CHESTER, VA 23831-4612
(804) 252-0126
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704016147
VA
251S00000X
Community/Behavioral Health Agency
212003001
VA
Other
Enumeration date
10/14/2024
Last updated
11/26/2024
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