Individual
MARY ELISABETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 LEAKE ST STE 106, CARTERSVILLE, GA 30120-3562
(770) 615-0218
Mailing address
117 DAVIS DR, CARTERSVILLE, GA 30120-2408
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
009275
GA
Other
Enumeration date
09/18/2023
Last updated
09/19/2023
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