| NPI | 1801193834 |
|---|---|
| Former Name | EDNA FAYE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ 17302) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 5034) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 15179) | |
| 101YM0800X Counselor, Mental Health (Licence: LA 4179) | |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2024-06-04 |