Individual
MRS. SHARETTA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
6210 TANGLEWOOD DR, JACKSON, MS 39213-7939
(601) 362-4471
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C6334
MS
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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