Individual
MR. QUASHON ADAIRE JOHNSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6635 BASS RD BLDG 92145, FORT BENNING, GA 31905-5602
(706) 257-7205
(706) 626-0827
Mailing address
119 BROOK TRL, NEWNAN, GA 30265-6140
(404) 735-1366
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7087
OK
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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