Doctor Name: | MRS. SHIRLEY B JOHNSON |
NPI Number: | 1023194685 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED., LBSW, LPC |
License Number: | 18348 |
Business Practice Address: | 3806 N Main St Victoria, TX - 779012638 |
Business Phone Number: | 3614850899 |
Business Fax Number: | 3614850817 |
Mailing Address: | 3806 N Main St, VICTORIA |
State: | TX |
Postal Code: | 779012638 |
Phone Number: | 3614850899 |
Fax Number: | 3614850817 |
NPI Enumeration Date: | 10/27/2006 |
NPI Last Update Date: | 07/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 18348 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |