Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 83340 | TX |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 83340 | TX |
Y | 101YM0800X | Mental Health Counselor | 83340 | TX |
N | 225C00000X | Rehabilitation Counselor | 83340 | TX |
NPI | 1134594328 |
---|---|
Provider Name | Ashley Johnson |
First Address | Rosharon, TX 77583-1084 |
Second Address | Austin, TX 78701-3101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2015 |
Last Update Date | 26/12/2021 |