Individual
MARQUETTA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
205 INGRAM BLVD, WEST MEMPHIS, AR 72301-3423
(870) 739-6818
(870) 662-6826
Mailing address
1910 MADISON AVE # 2153, MEMPHIS, TN 38104-2620
(901) 201-0308
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10492-C
AR
1041C0700X
Clinical Social Worker
9285
TN
Other
Enumeration date
09/29/2022
Last updated
07/05/2024
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