| Doctor Name: | KIMBERLY JOHNSON |
| NPI Number: | 1013073329 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LPC004612 |
| Business Practice Address: | 126 Enterprise Path Ste 206 Hiram, GA - 301412654 |
| Business Phone Number: | 6785670920 |
| Business Fax Number: | 6785670950 |
| Mailing Address: | 1401 Burleyson Dr Ste 1, DALTON |
| State: | GA |
| Postal Code: | 307202522 |
| Phone Number: | 7062705002 |
| Fax Number: | 7062405111 |
| NPI Enumeration Date: | 12/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC004612 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |