Individual
MICHELLE R JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2707 JEANETTE ST, VICKSBURG, MS 39180-4635
(601) 218-7041
Mailing address
2707 JEANETTE ST, VICKSBURG, MS 39180-4635
(601) 218-7041
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0102
MS
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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