Individual
LATOYA JENNEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1079 THORNBERRY DR STE D, MADISONVILLE, KY 42431-1600
(270) 874-2560
Mailing address
111 MERIDIANS WAY, OAK GROVE, KY 42262-9390
(931) 802-7933
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPCCCA00225610
KY
Other
Enumeration date
04/20/2016
Last updated
04/20/2016
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