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Individual

MR. CORANDLE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
83 US HIGHWAY 169 NORTH, PHENIX CITY, AL 36870-8552
(706) 315-9040
(334) 448-8836
Mailing address
PO BOX 1181, FORTSON, GA 31808-1181
(706) 315-9040
(334) 448-8836

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2240
AL

Other

Enumeration date
01/02/2007
Last updated
07/08/2007
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