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General NPI Number Information
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NPI Number | 1104314459
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Entity Type | Individual
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Provider Name | ALLANA DIANNE JOHNSON LPC
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Gender | Female
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 04/23/2018
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Provider Practice Location Address
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Address Line | 6130 WOODSIDE EXECUTIVE CT
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City | AIKEN
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State | SC
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Zip | 29803-3820
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Country | US
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Telephone | 803-226-0190
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Fax | 803-226-0258
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Provider Business Mailing Address
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Address Line | 881 WILLOW LK
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City | EVANS
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State | GA
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Zip | 30809-8031
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Country | US
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Telephone | 706-414-5051
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6832
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License Number State | SC
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