Individual
KERMIT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
2015 NE LOOP 410, SAN ANTONIO, TX 78217-5411
(210) 987-3366
Mailing address
2015 NE LOOP 410, SAN ANTONIO, TX 78217-5411
(210) 987-3366
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14034
TX
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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