Individual
FORMKA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
1 E CHASE ST STE 1108, BALTIMORE, MD 21202-2564
(443) 991-1370
Mailing address
1113 E PRESTON ST, BALTIMORE, MD 21202-5621
(443) 991-1370
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
22602
MD
Other
Enumeration date
03/21/2017
Last updated
01/03/2022
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