Individual
MS. DELISEA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
508 DEEP EDDY AVE, AUSTIN, TX 78703-4555
(512) 956-6463
Mailing address
1316 WYSTERIA LN, BURLESON, TX 76028-2742
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
57501
TX
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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