Individual
JACQUELYNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW,PIP
Contact information
Practice address
9018 COTTON FIELD CIR, TUSCALOOSA, AL 35405-9643
(205) 292-8276
Mailing address
9018 COTTON FIELD CIR, TUSCALOOSA, AL 35405-9643
(205) 292-8276
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1394-3879C
AL
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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