Individual
Y. DIANA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.C.D.C.
Contact information
Practice address
7901 CAMERON RD STE 2-139, AUSTIN, TX 78754-3802
(512) 910-5188
Mailing address
PO BOX 144031, AUSTIN, TX 78714-4031
(512) 910-5188
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15020
TX
Other
Enumeration date
09/20/2019
Last updated
11/30/2019
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