Individual
JACQUELINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1550 LATIMER ST, PHILADELPHIA, PA 19102-4417
(215) 802-3533
Mailing address
6711 GERMANTOWN AVE UNIT 18953, PHILADELPHIA, PA 19119-2181
(215) 802-3533
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/11/2019
Last updated
01/16/2020
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