Individual
JONATHAN M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SOCIAL WORKER
Contact information
Practice address
2301 FOREST LANE, SUITE 400, GARLAND, TX 75042
(972) 272-1633
(972) 487-0192
Mailing address
2301 FOREST LANE, SUITE 400, GARLAND, TX 75042
(972) 272-1633
(972) 487-0192
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
50715
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50715
LICENSE NUMBER
TX
Enumeration date
05/09/2007
Last updated
07/08/2007
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