Individual
EBONY MICHELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA,ADT
Contact information
Practice address
2808 CARVER RD, BALTIMORE, MD 21225-1312
(667) 967-3639
Mailing address
2808 CARVER RD, BALTIMORE, MD 21225-1312
(667) 967-3639
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/18/2020
Last updated
06/18/2020
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