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Individual

KELLY R JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
4098 LIBRA DR, ORLANDO, FL 32816-3333
(407) 823-2924
(407) 823-4352
Mailing address
PO BOX 163333, ORLANDO, FL 32816-3333
(407) 823-2924
(407) 823-4352

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH 12142
FL

Other

Enumeration date
04/05/2016
Last updated
04/05/2016
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