Individual
LATASHA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41 W MERRICK RD SUITE 2, VALLEY STREAM, NY 11580
(516) 459-2920
Mailing address
18825 MANGIN AVE, SAINT ALBANS, NY 11412-2317
(718) 290-7683
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
P104838
NY
Other
Enumeration date
01/17/2022
Last updated
01/17/2022
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