Individual
DR. CASSANDRA LATASHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
630 ELLIS ST STE 3A, AUGUSTA, GA 30901-1464
(706) 550-0723
(706) 739-4624
Mailing address
630 ELLIS ST STE 3A, AUGUSTA, GA 30901-1464
(706) 550-0723
(706) 739-4624
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC010321
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC010321
LICENSED PROFESSIONAL COUNSELOR
GA
Enumeration date
06/13/2015
Last updated
05/30/2024
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