Individual
MS. GWENDOLY DENISE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QP
Contact information
Practice address
1915 CHAPEL HILL RD, DURHAM, NC 27707-1177
(919) 358-1204
Mailing address
1915 CHAPEL HILL RD, DURHAM, NC 27707-1177
(919) 358-1204
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP1600X
Pastoral Counselor
—
—
174400000X
Specialist
—
—
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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