Individual
MRS. CAROLYN JEAN JOHNSON FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
118 BERMUDA LN, PALESTINE, TX 75803-5435
(903) 922-1725
Mailing address
118 BERMUDA LN, PALESTINE, TX 75803-5435
(903) 922-1725
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
79323
TX
101YP2500X
Professional Counselor
79323
TX
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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