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Individual

MS. JUANITA S. JOHNSON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
L.P.C.

Contact information

Practice address
20 W BANK ST, SUITE 5, PETERSBURG, VA 23803-3279
(804) 863-1689
(804) 863-1695
Mailing address
1093 ASBURY CHURCH RD, HALIFAX, VA 24558-2947
(434) 476-7139

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
07010026
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
089366
VA
05
117957
VA
05
140491
VA
05
224111
VA
Enumeration date
06/15/2006
Last updated
07/09/2007
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