Individual
MRS. ANTOINETTE V JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED MENTAL HE
Contact information
Practice address
10307 PLEASANT VIEW DR, LEESBURG, FL 34788-3853
(352) 742-7566
Mailing address
10307 PLEASANT VIEW DR, LEESBURG, FL 34788-3853
(352) 742-7566
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IMH5785
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH5785
—
FL
Enumeration date
05/28/2009
Last updated
07/17/2013
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