Individual
BIANCA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
142 BLUE CREEK LN, LOGANVILLE, GA 30052-8225
(678) 732-4685
Mailing address
PO BOX 390934, SNELLVILLE, GA 30039-0016
(678) 732-4685
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
APC007225
GA
101YP2500X
Professional Counselor
Primary
LPC014784
GA
Other
Enumeration date
04/08/2021
Last updated
03/13/2025
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