Individual
LATISHA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3478 BUCHANAN AVE, MEMPHIS, TN 38122-4922
(901) 407-5386
Mailing address
3478 BUCHANAN AVE, MEMPHIS, TN 38122-4922
(901) 407-5386
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
414374399
TN
251E00000X
Home Health Agency
Primary
41-4374399
TN
Other
Enumeration date
02/19/2026
Last updated
03/03/2026
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