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Individual

MR. JOHNNY NUTT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
1120 N PACIFIC ST, SUITE 5, MINEOLA, TX 75773-1870
(903) 569-9110
(903) 569-9155
Mailing address
1120 N PACIFIC ST, SUITE 5, MINEOLA, TX 75773-1870
(903) 569-9110
(903) 569-9155

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5040
TX
101YP2500X
Professional Counselor
003020
TX

Other

Enumeration date
10/06/2005
Last updated
09/11/2025
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