| NPI | 1336419159 |
|---|---|
| Former Name | KRYSTAL JOY JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 66619) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 66619) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2018-10-01 |