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Individual

LATONYA RUTH JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
817 BROWN ST, BISHOPVILLE, SC 29010-1178
(843) 484-9414
Mailing address
411 E NEW ST, TIMMONSVILLE, SC 29161-1543
(843) 496-3810

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SC

Other

Enumeration date
11/03/2019
Last updated
11/03/2019
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