Individual
JOHNNY WAYNE CARNELL II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSW
Contact information
Practice address
2151 CENTURY LN, JOHNSON CITY, TN 37604-4469
(423) 926-2500
(423) 926-5999
Mailing address
807 UNIVERSITY PKWY BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 439-4071
(423) 439-4060
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5840
ST LICENSE
TN
Enumeration date
02/11/2009
Last updated
01/20/2015
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