Individual
DENITA M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
805 S WHEATLEY ST, RIDGELAND, MS 39157-5000
(601) 572-3700
Mailing address
PO BOX 492, MENDENHALL, MS 39114-0492
(601) 622-0457
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/30/2007
Last updated
07/08/2007
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