Individual
CHASITY L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1225 NORTH STATE STREET, JACKSON, MS 39202
(601) 968-1362
(601) 292-4592
Mailing address
PO BOX 23090, MORGANTI - ADMIN FINANCE, JACKSON, MS 39225-3090
(601) 968-1362
(601) 292-4592
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D0920
MS
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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