Individual
STACIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1707 US HIGHWAY 72 W, ATHENS, AL 35611-2948
(256) 466-2131
Mailing address
2024 BRAYDEN DR SW, DECATUR, AL 35603-2476
(256) 654-4820
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/18/2021
Last updated
01/18/2021
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