| NPI | 1114175841 |
|---|---|
| Former Name | SHONTINA PATRYCE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005198) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC SW11594) |
| Enumeration Date | 2008-09-06 |
| Last Update Date | 2018-08-26 |