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General NPI Number Information
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NPI Number | 1538633045
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Entity Type | Individual
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Provider Name | SASHA JOHNSON MS. ALC
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Gender | Female
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 01/17/2019
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Provider Practice Location Address
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Address Line | 814 MONTERO DR
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City | MONTGOMERY
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State | AL
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Zip | 36110-3224
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Country | US
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Telephone | 334-328-5070
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Fax |
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Provider Business Mailing Address
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Address Line | 814 MONTERO DR
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City | MONTGOMERY
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State | AL
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Zip | 36110-3224
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Country | US
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Telephone | 334-328-5070
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C2819A
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License Number State | AL
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