Individual
MRS. PHYLLIS W JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
325 EBENEZER RD, KNOXVILLE, TN 37923
(865) 670-0988
(865) 670-1991
Mailing address
325 EBENEZER RD, KNOXVILLE, TN 37923
(865) 670-0988
(865) 670-1991
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC788
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3130541
BCBS
TN
Enumeration date
02/02/2007
Last updated
07/08/2007
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