Individual
KERA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
608 S HIGHWAY 65 82 STE B, LAKE VILLAGE, AR 71653-1744
(870) 265-3711
Mailing address
602 N WALTON BLVD, BENTONVILLE, AR 72712-4576
(479) 464-1060
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/31/2012
Last updated
05/31/2012
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