| Doctor Name: | SHIRLEY KAY JOHNSON |
| NPI Number: | 1225300957 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICENSED GRIEF COUNS |
| License Number: | CERTIFIED GRIEF COUN |
| Business Practice Address: | 1000 Grosser Rd Ste 2a Gilbertsville, PA - 195259225 |
| Business Phone Number: | 4846805098 |
| Business Fax Number: | 6103670101 |
| Mailing Address: | 950 Ruby Cir, GILBERTSVILLE |
| State: | PA |
| Postal Code: | 195258414 |
| Phone Number: | 4846805098 |
| Fax Number: | 6103670101 |
| NPI Enumeration Date: | 01/26/2012 |
| NPI Last Update Date: | 01/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | CERTIFIED GRIEF COUN |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |