Individual
KEYDRA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
611 PENNSYLVANIA AVE SE # 415, WASHINGTON, DC 20003-4303
(202) 643-6018
Mailing address
5711 BALTIMORE AVE APT 304, HYATTSVILLE, MD 20781-1670
(516) 303-4535
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
103962
NY
104100000X
Social Worker
LG50083757
DC
1041C0700X
Clinical Social Worker
095315
NY
1041C0700X
Clinical Social Worker
Primary
LC200002602
DC
Other
Enumeration date
06/14/2021
Last updated
05/18/2023
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