Individual
DETRIAL WILLIAMS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMFT
Contact information
Practice address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8506
(813) 239-8394
Mailing address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8506
(813) 239-8394
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
PMFT 130
FL
Other
Enumeration date
08/18/2010
Last updated
09/18/2015
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