Individual
DEIDRE L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 374-5600
Mailing address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 374-5600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
SW18067
FL
Other
Enumeration date
08/25/2017
Last updated
02/10/2021
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