Individual
JAYNE ANNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6440 1ST AVE N, ST PETERSBURG, FL 33710-8402
(727) 341-0097
Mailing address
1801 BAY BLVD APT 4, INDIAN ROCKS BEACH, FL 33785-2924
(727) 596-4344
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SW7415
FL
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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