Individual
COURTNEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1058 ASHER WAY STE 400, TYLER, TX 75703-6076
(903) 922-6667
Mailing address
610 AN COUNTY ROAD 404, PALESTINE, TX 75803-1548
(903) 922-6667
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
93862
TX
225200000X
Physical Therapy Assistant
2104098
TX
Other
Enumeration date
08/23/2018
Last updated
02/08/2024
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