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Individual

MRS. KRYSTAL LEE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
7102 GLEN FOREST DR, GREENVILLE, SC 29607-6111
(864) 356-5679
(866) 603-7688
Mailing address
7102 GLEN FOREST DR, GREENVILLE, SC 29607
(864) 356-5679
(866) 603-7688

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7203
SC

Other

Enumeration date
12/06/2012
Last updated
12/06/2012
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