Individual
AEISHA NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1385 HARKEE DR, FLORISSANT, MO 63031-3434
(314) 831-1391
Mailing address
1500 N ELIZABETH AVE, FERGUSON, MO 63135-1240
(314) 915-1729
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2020011986
MO
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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