Provider Information for 1376844472
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VANESIA REGINA JOHNSON LCSW
Sex: Female
NPI: 1376844472
Last Updated: 2012-06-20
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1376844472 | ||||||||||||
| Enumeration Date | 2010-11-05 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 2234 SUGAR LAND, TX 77487-2234 United States Phone: 713-530-8372 | Fax: | ||||||||||||
| Primary Practice Address | 16106 DAWN MARIE LN SUGAR LAND, TX 77498-7523 United States Phone: 832-429-6965 | Fax:281-809-4596 | ||||||||||||
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