Doctor Name: | KANICE JOHNS |
NPI Number: | 1043619935 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | BH002345 |
Business Practice Address: | 390 Waterloo Blvd Exton, PA - 193412603 |
Business Phone Number: | 6103636499 |
Business Fax Number: | |
Mailing Address: | 410 N Prince St, LANCASTER |
State: | PA |
Postal Code: | 176033010 |
Phone Number: | 6103635500 |
Fax Number: | |
NPI Enumeration Date: | 08/18/2014 |
NPI Last Update Date: | 08/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | BH002345 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |