Individual
TAYLOR AMELIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
233 W LOUISE ST, FAYETTEVILLE, AR 72701-3320
(501) 658-2542
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
AR
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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