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Individual

ANTWINE DEON JOHNSON SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCADC

Contact information

Practice address
2131 46TH ST, PENNSAUKEN, NJ 08110-2011
(609) 707-3444
Mailing address
761 CUTHBERT BLVD, CHERRY HILL, NJ 08002-3417
(856) 890-9449

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00332600
NJ

Other

Enumeration date
09/14/2022
Last updated
09/14/2022
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