Individual
EMILY KEITH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4769 E HIGHWAY 82, LAKE VILLAGE, AR 71653-6065
(662) 822-0318
Mailing address
4769 E HIGHWAY 82, LAKE VILLAGE, AR 71653-6065
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1519
MS
133V00000X
Registered Dietitian
Primary
1630
AR
Other
Enumeration date
07/19/2024
Last updated
07/19/2024
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