Individual
CRYSTAL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC-AD
Contact information
Practice address
21 INDUSTRIAL PARK DR STE 104D, WALDORF, MD 20602-2751
(301) 818-0030
Mailing address
21 INDUSTRIAL PARK DR STE 104D, WALDORF, MD 20602-2751
(301) 818-0030
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC2302
MD
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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