Individual
MR. JOHNNY R WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCI CACI
Contact information
Practice address
601 GREGG AVE, FLORENCE, SC 29501
(843) 664-3919
Mailing address
PO BOX 6196, FLORENCE, SC 29502
(843) 664-3919
(843) 669-6122
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LPCI H 4679
SC
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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