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Individual

JACQUELINE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
325 EBENEZER RD, KNOXVILLE, TN 37923-5310
(865) 670-0988
Mailing address
325 EBENEZER RD, KNOXVILLE, TN 37923-5310
(865) 670-0988

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3560
TN
101YP2500X
Professional Counselor
3560

Other

Enumeration date
03/04/2016
Last updated
03/04/2016
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