Individual
LATISHA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3150 E HERITAGE PKWY, FARMINGTON, AR 72730-5529
(479) 400-1140
(479) 400-1151
Mailing address
PO BOX 497, AUGUSTA, AR 72006-0497
(870) 347-3475
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P1412110
AR
Other
Enumeration date
08/15/2011
Last updated
01/05/2024
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