Individual
KENYATTA L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17304 BORROMEO AVE, PFLUGERVILLE, TX 78660-6073
(512) 680-8443
Mailing address
17304 BORROMEO AVE, PFLUGERVILLE, TX 78660-6073
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
64915
TX
1041C0700X
Clinical Social Worker
1144910027
UT
Other
Enumeration date
05/12/2023
Last updated
01/13/2025
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