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General NPI Number Information
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NPI Number | 1699884502
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Entity Type | Individual
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Provider Name | RHONDA G. JOHNSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 1830 DESTINY LN SUITE 106
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City | BOWLING GREEN
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State | KY
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Zip | 42104-1087
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Country | US
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Telephone | 270-904-5195
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Fax | 270-904-3648
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Provider Business Mailing Address
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Address Line | 1830 DESTINY LN SUITE 106
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City | BOWLING GREEN
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State | KY
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Zip | 42104-1087
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Country | US
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Telephone | 270-904-5195
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Fax | 270-904-3648
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1621
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License Number State | KY
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