Individual
REGINALD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7024 WOODSIDE DR, INDIANAPOLIS, IN 46260-3979
(317) 850-0615
Mailing address
7024 WOODSIDE DR, INDIANAPOLIS, IN 46260-3979
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10127669
IN
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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