Individual
INDIA MARISSA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
(901) 577-7427
Mailing address
1030 JEFFERSON AVENUE, MEMPHIS, TN 38104
(901) 523-8990
(901) 577-7427
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6272
TN
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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