Individual
ARDENA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
60 LIGHTWOOD DR, COVINGTON, GA 30016
(678) 467-2778
Mailing address
60 LIGHTWOOD DR, COVINGTON, GA 30016-1916
(678) 467-2778
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102164303C
—
GA
Enumeration date
02/20/2008
Last updated
06/27/2018
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