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Individual

DOROTHY MAE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BSL

Contact information

Practice address
5039 N 4TH ST, 1ST FLOOR, PHILADELPHIA, PA 19120-3832
(215) 456-0743
Mailing address
5039 N 4TH ST, 1ST FLOOR, PHILADELPHIA, PA 19120-3832
(215) 456-0743

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BH002783
PA

Other

Enumeration date
08/28/2015
Last updated
03/20/2018
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