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Individual

ALICE CACEDA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1935 MEDICAL DISTRICT DR # CL.05, DALLAS, TX 75235-7701
(415) 968-9378
Mailing address
1935 MEDICAL DISTRICT DR # CL.05, DALLAS, TX 75235-7701
(415) 968-9378

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
94696
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
362235165
IL
Enumeration date
08/02/2016
Last updated
07/17/2024
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