Individual
MRS. GWENDOLYN WATTS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSWC
Contact information
Practice address
9199 REISTERSTOWN ROAD, SUITE 214C, OWINGS MILLS, MD 21117
(410) 552-0773
(410) 552-0774
Mailing address
1425 LIBERTY ROAD, SUITE 208, ELDERSBURG, MD 21784
(410) 552-0773
(410) 552-0774
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
04393
MD
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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