Individual
TINA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
301 PALMETTO PARK BLVD, LEXINGTON, SC 29072-7872
(803) 996-1500
(803) 359-7291
Mailing address
301 PALMETTO PARK BLVD, LEXINGTON, SC 29072-7872
(803) 996-1500
(803) 359-7291
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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