Individual
GRACE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2008 BREMO ROAD SUITE 111, RICHMOND, VA 23226-4705
(804) 223-1399
Mailing address
9 E LEIGH ST APT A, RICHMOND, VA 23219-1371
(804) 306-5734
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0704015846
VA
Other
Enumeration date
04/26/2023
Last updated
06/26/2023
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