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Individual

MRS. KELLY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHCA

Contact information

Practice address
9247 BROADWAY STE BB, MERRILLVILLE, IN 46410-7008
(219) 323-3311
Mailing address
9247 BROADWAY STE BB, MERRILLVILLE, IN 46410-7008

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
88001503A
IN

Other

Enumeration date
10/10/2022
Last updated
10/10/2022
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