Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 2920 | AL |
NPI | 1003105321 |
---|---|
Provider Name | Monique S Johnson |
First Address | Birmingham, AL 35205-4913 |
Second Address | Birmingham, AL 35205-4913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2011 |
Last Update Date | 09/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LPC2 | AMERICAN BEHAVIORAL HEALTH (01) | AL |