Individual
MS. T. JEANETTE JOHNSON-WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
124 MALLARD ST, GREENVILLE, SC 29601-4046
(864) 452-0557
Mailing address
124 MALLARD ST, GREENVILLE, SC 29601-4046
(864) 452-0557
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9283
SC
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
07/02/2009
Last updated
05/02/2013
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