Individual
MRS. VIVIAN YVETTE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
150 OLD LIBERTY ROAD, GLOSTER, MS 39638
(904) 278-5036
Mailing address
150 LIBERTY ROAD, GLOSTER, MS 39638
(904) 278-5036
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
TO214
MS
Other
Enumeration date
09/08/2009
Last updated
09/08/2009
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