Individual
DAISHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
809 W VINE ST, LIMA, OH 45804-1054
(419) 222-4474
(419) 222-7044
Mailing address
1502 EDGEWOOD DR, LIMA, OH 45805-1013
(419) 222-4474
(419) 222-7044
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1366825697
OH
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366825697
—
OH
Enumeration date
07/06/2015
Last updated
07/07/2015
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