Individual
WAYNE BEASLEY JOHNSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
248 ADDIE ROY RD # A103, AUSTIN, TX 78746-4131
(512) 265-0709
Mailing address
9810 DALLUM DR APT B, AUSTIN, TX 78753-4312
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
112029
TX
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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