Individual
ANNIE R JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
300 S 12TH ST, NEWARK, NJ 07103-1960
(973) 622-4934
(973) 622-5820
Mailing address
300 S 12TH ST, NEWARK, NJ 07103-1960
(862) 668-6149
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LCOOO63500
NJ
Other
Enumeration date
02/14/2022
Last updated
02/14/2022
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