Individual
THERESA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ALC, MS
Contact information
Practice address
1917 BLACK CREEK PKWY, GADSDEN, AL 35904-4584
(256) 543-3614
Mailing address
1917 BLACK CREEK PKWY, GADSDEN, AL 35904-4584
(256) 543-3614
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C2904A
AL
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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