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Individual

KENYA DERAY COUNTEE-JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-8424
Mailing address
11 KWANZAN ST, TANEYTOWN, MD 21787-2144
(443) 789-7686

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R155914
MD

Other

Enumeration date
10/31/2022
Last updated
10/31/2022
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