Individual
ANDRE R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC, OT
Contact information
Practice address
7717 PECAN LEAF RD, SEVERN, MD 21144-6938
(410) 303-2055
Mailing address
7717 PECAN LEAF RD, SEVERN, MD 21144-3614
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
71367771
MD
225X00000X
Occupational Therapist
03491
MD
Other
Enumeration date
05/17/2013
Last updated
06/21/2024
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