Individual
KEJUIANA L. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 N MAIN ST, HINESVILLE, GA 31313-2509
(678) 664-4003
Mailing address
PO BOX 1417, HINESVILLE, GA 31310-8417
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
004421
GA
101YP2500X
Professional Counselor
Primary
009587
GA
Other
Enumeration date
08/05/2014
Last updated
07/11/2017
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