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Individual

MR. DWAYNE ARRA JOHNSON SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1276 N CLYBOURN AVE, CHICAGO, IL 60610-2003
(312) 337-1073
Mailing address
807 MARION WAY, CHICAGO HEIGHTS, IL 60411-1949
(773) 676-3675

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.024414
IL

Other

Enumeration date
01/05/2023
Last updated
01/05/2023
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