Individual
LA TONYA N JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
723 HAWKINS DR, ELIZABETHTOWN, KY 42701-1063
(270) 900-0373
(270) 900-0426
Mailing address
PO BOX 1086, ELIZABETHTOWN, KY 42702-1086
(270) 900-0373
(270) 900-0426
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
175226
KY
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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