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Individual

MS. SATONIA RENAE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
IMH

Contact information

Practice address
7413 SHERREN DR., TAMPA, FL 33619-4737
(813) 417-9162
Mailing address
7413 SHERREN DR, TAMPA, FL 33619-4737
(813) 417-9162

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
IMH 14002
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
IMH 14002
REGISTERED MENTAL HEALTH COUNSELOR INTERN
FL
Enumeration date
10/07/2015
Last updated
10/07/2015
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