Individual
ANDRE R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC, OT
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
71367771
MD
101YP2500X
Professional Counselor
Primary
LGP15116
MD
225X00000X
Occupational Therapist
03491
MD
Other
Enumeration date
05/17/2013
Last updated
07/17/2026
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