Individual
MR. MITCHELL EDWARD JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
1776 CLAY AVE, BRONX, NY 10457-7239
(347) 603-5934
Mailing address
1776 CLAY AVE, BRONX, NY 10457-7239
(347) 603-5934
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17767
NY
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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