Individual
DIANNE STANFORD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
601 BOMBAY LN, ROSWELL, GA 30076-5828
(770) 754-4674
(770) 754-4676
Mailing address
5222 HUNTINGFORD TER, MARIETTA, GA 30068-1728
(770) 598-1700
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW005475
GA
1041C0700X
Clinical Social Worker
CSW005263
GA
Other
Enumeration date
10/29/2011
Last updated
08/07/2015
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