Provider Information for 1578108221
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Mrs. AMBER MICHELLE JOHNSON LPC, MA
Sex: Female
NPI: 1578108221
Last Updated: 2019-11-15
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1578108221 | ||||||||
| Enumeration Date | 2019-11-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 125 EDD LASYONE RD PINEVILLE, LA 71360-3030 United States Phone: 304-910-1589 | Fax: | ||||||||
| Primary Practice Address | 4207 PARLIAMENT DR STE B ALEXANDRIA, LA 71303-2720 United States Phone: 318-787-6805 | Fax:318-787-6818 | ||||||||
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