Individual
UTRENA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
719 N DUNCAN BYP STE K, UNION, SC 29379-8605
(864) 466-5428
Mailing address
719 N DUNCAN BYP STE K, UNION, SC 29379-8605
(864) 466-5428
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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