Individual
NAKISHA EVAI JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
134 E REBOUND RD, LANCASTER, SC 29720-7712
(843) 610-1069
Mailing address
134 E REBOUND RD, LANCASTER, SC 29720-7712
(843) 610-1069
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1307264
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
508050
VA
101YP2500X
Professional Counselor
007585
GA
101YP2500X
Professional Counselor
11681
NC
101YP2500X
Professional Counselor
Primary
4905
SC
Other
Enumeration date
04/10/2011
Last updated
09/06/2016
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