Individual
EARNEST JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1110 CLAY ST, VICKSBURG, MS 39183-2912
(601) 738-5820
(601) 738-5083
Mailing address
1110 CLAY ST, VICKSBURG, MS 39183-2912
(601) 738-5820
(601) 738-5083
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
W3091
MS
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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