Individual
REBECCA LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADCII
Contact information
Practice address
1800 NE 32ND AVE, LAKE CITY, FL 34470
(352) 742-6170
Mailing address
612 RIVER ST, VALDOSTA, GA 31601-5400
(229) 412-1739
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0742
GA
Other
Enumeration date
08/29/2024
Last updated
08/29/2024
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