Individual
CHASITY DAUGHERTY7 JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LEP, NCSP
Contact information
Practice address
500 W 2ND AVE, TENINO, WA 98589
(360) 264-3400
Mailing address
8265 BALSA AVE, YUCCA VALLEY, CA 92284-6112
(304) 416-4339
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
3744
CA
Other
Enumeration date
04/02/2021
Last updated
04/02/2021
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